Maryland's Obamacare Exchange Launch Was Also a Disaster

The botched launch of Obamacare’s federal
exchange system was front and center in the news for the last three
months of 2013. All the attention paid to the federal system, which
covered 36 states, distracted somewhat from the fact that several
of the state-run exchanges were arguably even worse off.

One of those states was Maryland—which, funny enough, was
repeatedly touted as an example of how Obamacare’s exchanges could
work if state officials wanted them to work and were proactive
about implementation. President Obama went to Maryland to deliver a
big health care speech a few days before the October launch of the
exchanges, praising Maryland’s elected officials for their efforts.
The state was even
given a $6.7 million “early innovator” grant by the federal
government, which hoped that the Maryland exchange could serve as a
model for other states.

But state and federal officials working on the exchanges had
known for months that Maryland’s exchange build out had huge
problems, according to a
big Washington Post feature from this weekend on the state’s
disastrous exchange development process.

According to the Post’s report, an outside audit from
the consulting firm BerryDunn warned state officials in a late 2012
presentation that they were underprepared, and that there were big
risks to the project. For example,  the report says, “no one
could produce for BerryDunn standard project plans showing a
timeline and checklist for how the main IT contractor…would get the
job done.” Nor was there anyone in charge. Even after the state
finally hired an exchange director to manage the project, BerryDunn
continued to warn that the project lacked a clear plan and timeline
for completion.

In June of 2013, the project team managed to cobble a basic
system together in order to pass a basic test proving that their
system could talk to the federal data hub. But two months later,
when it came time to show the system could do more than that, the
exchange crashed and burned, reports the Post:

On Aug. 26, five weeks before the launch date, Maryland faced
its final major test with federal overseers, a more thorough
demonstration of how each part of its system would work. This one
did not go as well. When the test got to the part of having a
fictitious person choose a health plan, the Web site crashed. It
also could not fully send enrollment data to insurers or e-mail
Marylanders when they successfully selected a plan — something it
still cannot do.

A final prelaunch test the next month wasn’t much better:

… Testers filed their final report on Sept. 13, calling the
last version of the software they could review “extremely
unstable.” Internal testing of one aspect of the site found 449
defects, almost half of which would probably trouble the final
release.

Not surprisingly, launch day was a mess:

More than 24 hours after the launch, there were just four people
who had selected plans and eight more who appeared to have logged
on.

An IT contractor wrote to state officials on Oct. 2
wondering if the four were “legitimate,” since contractors could
not even access the site. She questioned if they might be
fictitious accounts from prior phases of testing.

Maryland’s troubled experience trying to build its own exchange
isn’t unique. Oregon, Minnesota, Vermont, Massachusetts, and Hawaii
have all had (and in some cases still have) serious glitches with
their exchanges, despite
hundreds of millions in federal grants doled out to states
building those systems. (Maryland alone got a total of $171 million
from the federal government.) The widespread launch failures of so
many exchanges, at both the federal and state levels, suggests that
many of the problems were inherent in the basic conception of the
exchanges, and that even if there had been near universal political
support for implementation, failure was at least as likely as
success.