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Despite Major Fixes, Maryland Health Site Still Has Glitches

Some policymakers have suggested that more extreme remedies might be needed, such as scrapping the state exchange and joining the federal one.

Less than two days after Gov. Martin O'Malley declared that Maryland's online insurance marketplace finally worked for most consumers, a server crashed Monday, the call center became overwhelmed and the governor announced he was bringing in another contractor to improve the website.

Some consumers and advocacy groups reported Monday that the website where consumers can buy health plans under the federal Affordable Care Act is easier to navigate. But others said they are still running into frozen screens, error messages and other problems that have plagued Maryland Health Connection since it launched Oct. 1.

"It's crashing all over the place," said Peter Beilenson, who has served in local health departments and now runs the insurance co-op Evergreen Health Cooperative Inc. He spoke after several failed attempts to enroll people through the exchange. "It's stopping at various parts. Bottom line, no, not functional."

O'Malley's administration has faced intense criticism over the glitch-prone online portal, which has had one of the worst rollouts in the country. On Monday, Republicans called for a special committee with subpoena powers to investigate what went wrong.

The Democratic governor pledged a number of new initiatives Monday after announcing Saturday night that nine "major issues" with the exchange had been fixed and that the site was "functional for most citizens."

As part of the announcement, he and Lt. Gov. Anthony G. Brown said the state hired Columbia-based Optum/QSSI, an information technology company that helped fix the federal exchange. And they said CareFirst BlueCross BlueShield, Maryland's largest insurer, had agreed to extend the deadline to enroll for coverage beginning Jan. 1.

In addition, they said exchange officials would keep the call center open longer and reach out to consumers who have begun, but not completed, the enrollment process.

"It's not glitch-free, but functional for most users," O'Malley said of the exchange. "It's not perfect by any means."

Some fellow Democrats, including Rep. John Delaney, have questioned whether more extreme remedies are needed, such as scrapping the state exchange and joining the federal one. States had the option to create their own websites to help people buy private insurance, and Maryland was one of the first to embrace the idea.

O'Malley and Brown, the point man on efforts to implement Obamacare in Maryland, did not rule out a move to the federal exchange.

"We're for whatever works," O'Malley said.

"We're keeping our options open," said Brown, who is running to replace term-limited O'Malley in next year's election.

Already, state officials have brought on new leadership for the exchange, asking Isabel FitzGerald, secretary of the Maryland Department of Information Technology, to lead the IT effort.

Last week, Brown declined to say when state officials would complete the nine fixes identified by O'Malley, who set a mid-December deadline to complete them. Then, two days later, O'Malley said he would meet the self-imposed deadline, and his spokeswoman said that meant by Dec. 20. Both have said they did not know of the extent of the problems before the site's launch but now get daily updates.

On Monday, O'Malley blamed some continued glitches on problems with a federal hub over the weekend, though he added that most people were not affected. The state site must interface with multiple parties, including insurers and the federal government.

Then a server went down for an hour Monday afternoon, which also might have caused some problems for users, said Dori Henry, a spokeswoman for the exchange. The server was taken down manually and will be fixed. And some consumers experienced busy signals Monday when phoning the call center, which happens when lines reach capacity, Henry said.

Henry said exchange staff monitor call center tickets daily and are not seeing tickets related to issues previously seen, such as the screen freezing on the enrollment button.

The glitches add frustration to stress, as people rush to get coverage by the first of year. That deadline for CareFirst insurance has been extended to Dec. 27. For other insurance plans, the deadline is Dec. 23, though state officials said they are discussing similar extensions with other carriers.

Sheila Mackertich, who heads enrollment efforts for HealthCare Access Maryland, said Monday she faced the same problems that have persisted with the site since it launched -- frozen screens, enrollment errors and sluggishness.

"We were not successful at moving people through," she said.

Others said the website finally began working for them this weekend.

Tom Myers, a stand-up comedian who said he works two other jobs to make ends meet, first tried to sign up for insurance after Thanksgiving, but the site was slow and it took hours to set up an account. In between comedy gigs, his job as an assistant restaurant manager and his part-time work as a youth sports announcer, Myers, 30, worked on his application, but the Maryland Health Connection was sluggish and froze.

On Sunday, Myers said he logged on, zipped through and discovered he was eligible for Medicaid. With coverage through that program, he will get health coverage for the first time in nearly a year.

"Everything was a lot quicker. When I clicked links, I didn't have to wait as long for the pages to load. It was really easy," Myers said. The Fallston resident added he was pleased his old back injury did not disqualify him for medical coverage.

"I consider myself in excellent health," Myers said. "I'm sort of at that invincible stage where I think there's not going to be anything wrong with me. But I want to have insurance, and I'm glad I have it."

Seedco and Healthy Howard, two nonprofits with state contracts to enroll people in plans, said they have seen continuous upgrades to the site. Brian Robinson, senior vice president with Seedco, said his staff used the site "extensively" on Monday and that it was "much improved."

Eric Masten, a spokesman for Healthy Howard said: "Our staff has been consistently busy today, and we have been enrolling consumers."

O'Malley said the state is still aiming for a goal to sign up 150,000 in private insurance and 110,000 in Medicaid plans by March 31, the deadline for Americans to enroll or face penalties.

He said the state must increase its numbers dramatically to meet its goal, but said enrollment gets better by the week.

"We're still on that track," O'Malley said.

Nearly 7,500 enrolled in private plans last week, up from more than 5,800 the previous week. About 900 consumers enrolled Friday -- a record for one day. Total enrollment, including Medicaid, is just shy of 30,000.

While the Maryland Democratic Party sent out an email praising the progress on the exchange, Republican leadership in the State House sent letters to the governor and top legislative leaders, endorsing a special investigation aided by an independent counsel. Among other tasks, the committee would be charged with finding out who knew what and when.

Harford County Executive David Craig, a Republican running for governor, said Monday he hasn't seen evidence the site is repaired and questioned whether it ever will be.

"I don't see it being fixed," he said.

Attorney General Douglas F. Gansler, a gubernatorial candidate who will challenge Brown in the Democratic primary, said he was pleased the governor has taken a leadership role moving the state forward, but that there was mounting public pressure to get the project right soon.

"The average person, they don't understand how we can spend that much on a website and still not have it work," Gansler said.

O'Malley acknowledged that people are frustrated about the botched site.

"You're all free to be outraged if it's not perfect from the outset," he said. "We're making it better by degrees."

The governor said the state is continuing to work down a list of technical problems. He noted that shoppers in the exchange still cannot see which doctors are in their plan options and are having trouble sending completed Medicaid applications to the agency.

Jim Yates, who is enrolled in Medicare, has tried since October to get private insurance for his wife, 60, and son, 22, through the exchange. The site crashed, the screen froze, and the 67-year-old Owings Mills man was met with error messages. When he finally was able to create an account, the screen would not work. He said the help desk told him the site does not work with the Internet Explorer browser.

Yates has given up on the site. Because his family doesn't qualify for subsidies, he can enroll directly through CareFirst, which is what he plans to do.

"Even if we could enroll using the website, I have no confidence that the information would ever get to the insurer accurately and that we would ever really have any coverage," he said.

(c) 2013 The Baltimore Sun