Technical problems, discord plagued health care site
By Meredith Cohn and Andrea K. Walker, The Baltimore Sun | |
McClatchy-Tribune Information Services |
Since
The revelations came just days before
Just two weeks before the launch, Pearce visited the prime contractor's Linthicum headquarters and found a room of empty seats. She fired off an email questioning the company's commitment to resolve problems and reminding the contractors of what was at stake: "Tonight, I am begging. I don't know how else to say it: we have got to make this a reality."
Despite her proddings, in-fighting between contractor
Today, the exchange website, called the Maryland Health Connection, is still not operating properly for all users, and officials are scrambling to meet deadlines for the public to obtain coverage. The problems have triggered criticism from some political pundits and have proven embarrassing for Gov.
Asked about the conflict between the project's contractors, Health Secretary Dr.
Lt. Gov.
"I certainly had the responsibility to ensure that if there were problems that required additional resources -- changes in legislation or policies -- that my responsibility was to make sure the exchange got what it needed," Brown said in an interview Friday. "And I relied on the reports that I received on the exchange. ...But at no point was a red flag ever brought to my attention as if we have a problem here, we are not going to meet the launch date, or if we do meet the launch date we are going to significantly underperform."
Brown said the exchange was created as an independent agency with autonomy. Its board is chaired by Sharfstein and includes heads of the state's health care commission and insurance administration.
Sharfstein and other health department employees were copied on a number of emails that discussed problems with the exchange. Sharfstein and Brown are co-chairmen of the overarching
The shake-up at the health exchange began last week. O'Malley and Brown charged the state's chief technology officer with overseeing fixes and put Sharfstein in charge of operations, taking away Pearce's main responsibilities in managing the exchange. A few days later, she resigned.
Pearce, who was hired in 2011 at a salary of
The emails provided by the state covered the two weeks before and after the website launch. They give only a limited behind-the-scenes view of creating and launching the exchange. Officials withheld an unknown number of emails, saying state law exempts them from disclosure because they involved the decision-making process of high-ranking executive officials.
The troubles in
The exchanges' bumpy rollout has galvanized critics of the health law, including Republicans in
O'Malley has also been a target of critics. He recently said that he wanted the website's major technical problems fixed by mid-December. That statement came a day after Sharfstein told state lawmakers it was unclear when the site would be entirely free of glitches -- an answer that drew criticism from Republicans and some Democrats.
Technology experts and those involved in setting up the websites say they are among the most complex web endeavors ever undertaken. State officials say there wasn't sufficient time to test the sites after the federal government released regulations related to the Affordable Care Act, and there was no pre-launch access to federal computers used to check consumers' eligibility for subsidies.
In
"Unlike buying a book online from Amazon, this process is more akin to applying for a passport, buying a home, and receiving an individually calculated tax credit all through a single web portal," O'Malley said Friday night. "We had more user glitches and user problems than we had hoped.
"A longer testing period might have allowed us to prioritize and address more of these problems before the launch date. Time and ultimate success will tell whether the decision to purchase off-the-shelf software and employ multiple contractor entities were good or bad decisions."
The companies
In early 2012, the state gave a
Sharfstein said Noridian will likely remain at work in its Linthicum offices beyond its contract's year-end expiration. The company has already been paid about
Noridian is ultimately responsible for delivering the system, Sharfstein said. EngagePoint, which is based in
The state first learned of the companies' "deep strains" in the three months before the website launched, according to documents in
Emails offer a glimpse at how their differences affected efforts to build the site and then fix post-launch problems. Pearce repeatedly questioned the contractors' commitment to the project after Gov.
On
Noridian was also criticizing the subcontractor it hired. On
The
The state provided few emails from the first day. In one, contractors said they would work on the firewall; Sharfstein said later in an interview that it was eventually altered to allow more users onto the site.
Problems persisted the next day. Pearce repeatedly asked for updates, but the answers appeared unsatisfactory, emails show.
"As the executives in charge of this program, I would like to understand from you exactly what is happening with the project and what you are doing to address the issues," she wrote to the contractors at
About a half-hour later, she wrote to the contractors, "Can you please provide an update on what is going on right now? Who is on site? What has anyone learned?"
Some of the companies' emails focused on achievements rather than dwelling on worsening problems.
Noridian CEO
But four days later McGraw notified state officials that the project manager was being replaced.
Meanwhile, Marylanders like
When the website opened, the
Goembel tried the website again that day, but says that after entering information about his identity, the site froze. Later he got a "server error" message. And still he had no online account.
Customer service started a paper application for him on
Over the next month, Goembel finally was able to create an account, but before he could buy a plan for his family of four with subsidies, he had to repeatedly call for help, enter the same information over and over online, tolerate error messages and recheck his eligibility for assistance three times.
Eventually, the family was enrolled in a plan significantly better and 40 percent cheaper than his previous coverage, with dental insurance.
Still, he's angry about the delays. "The
The dispute
Soon after the website's launch, emails among the contractors and exchange officials began to focus more on the dispute between Noridian and EngagePoint.
"We do not have time to waste," he emailed the contractors. "We hope your email was not intended to convey that the team will not proceed with conviction while it awaits the resolution of the prime issue."
The top executive at Noridian also stepped in by mid-month, holding a meeting with contractors, state officials and consultants it hired from
This was days before Noridian fired EngagePoint, sparking the angry email exchanges and dueling lawsuits between the companies. Noridian then sought to hire EngagePoint workers; EngagePoint sued and was met with a counter-suit.
"We are expected to do piecemeal work for Noridian after contract termination because you just woke up and decided you don't know what you are doing?" Goel wrote
Noridian's McGraw declined to be interviewed but said in a statement that his company was responsible for designing and implementing the system. It is a work in progress, he added.
"The complexity of this project has led to a number of major issues beyond what was anticipated; one example is federal regulations that redefined the system's requirements during development," he said in the statement. "Noridian and subcontractors have been working to systematically identify the cause and resolve each issue."
He declined to comment on the litigation with EngagePoint.
Goel, the EngagePoint CEO, said in a telephone interview that he was never told his company's work was unsatisfactory. The conflict with Noridian at first involved the way the project was being managed, he said.
After EngagePoint's firing, the companies battled over
Goel said problems with the exchange lie with the complexity of the job, connecting federal, state and insurer sites for the first time ever.
"It's not like Legos where everything is designed by the same company and fits beautifully," he said. "You're trying to get all the pieces to talk to each other."
He admits that emotions were running high immediately after the firing, but said he wants the exchange to succeed and has given Noridian information when asked.
EngagePoint also has contracts to work on exchanges in other states, including
Improvements have been made to
As of Friday, 3,758 people were enrolled in private insurance plans. More than 97,000 are expected to gain coverage under
Larry Burgee, an associate professor of information systems at
He added, "All this money was spent, and in
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