Health

Remember the HealthCare.gov Woes? State Exchanges Had the Same Problems

An information table advertising California's health care exchange sits in downtown Los Angeles in January.

An information table advertising California's health care exchange sits in downtown Los Angeles in January. // Reed Saxon/AP file photo

A parade of executives managing state online health care marketplaces shared stories with Congress on Thursday that echoed the turbulent tale of the federal site HealthCare.gov.

Troubles included glitchy launches, conflict with vendors and patchwork personnel changes. The fixes and workarounds instituted by state exchanges often included hiring 100 or more people to staff call centers and to manually process backlogged forms using state and federal grant money, the officials testified.

In most cases, though, as with the federal exchange, state exchanges were ultimately able to approach or meet enrollment targets despite technical challenges, officials told members of the House Oversight and Government Reform Committee.

HealthCare.gov was barely functional during the first weeks after its Oct. 1 launch but has operated generally well since Dec. 1 following two months of round-the-clock repairs that included rewriting software code, adding additional server space and redesigning an overly complex management structure.

Few of the 15 state exchanges performed as poorly as HealthCare.gov during their first weeks online, but several suffered severe outages and error rates. The Minnesota marketplace MNsure, for example, peaked at a 22 percent error rate in October, according to the St. Paul Pioneer Press.

HealthCare.gov was the primary Obamacare portal for 36 states, while 14 states and the District of Columbia built their own marketplaces.

Joshua Sharfstein, chairman of the Maryland Health Benefit Exchange Board, attributed his state marketplace’s difficulties to overreliance on commercial, off-the-shelf technology rather than systems that were custom-built for the exchange. Vendors of those commercial systems made promises they weren’t able to deliver on, he said.

Ultimately, the Maryland marketplace contracted with QSSI, the same vendor that managed the HealthCare.gov fix, to bring its operations on track.

As with past Oversight hearings on Obamacare, much of Thursday’s questioning was consumed by partisan bickering with Republicans claiming state officials were being dishonest about meeting enrollment targets and Democrats charging that Republicans were attempting to relitigate Obamacare’s passage.

Oversight Chairman Darrell Issa, R-Calif., argued that the decision to build, and then fix, state marketplaces and a federal marketplace had proven a costly failure and a waste of money.

“Whether you voted for the Affordable Care Act or you didn’t, redundant programs throughout most of 50 states that issued hundreds of millions of dollars per state to do the same thing again and again…[was] unreasonable, unnecessary and redundant in the planning,” Issa said. “For the states to all come together and use a common platform and common software was common sense.” 

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