Fourteen states and the District of Columbia told the federal government they could run their own health insurance exchanges, but three people leading their states’ exchanges have now left following problem-plagued rollouts of the online marketplaces.
The executive director of Maryland’s exchange, Rebecca Pearce, was the latest to go, resigning late last Friday. The head of Hawaii’s health insurance marketplace announced her resignation in November after delays in getting the exchange running and low signups in the first month.
And the head of Oregon’s health exchange took a medical leave earlier in December as state officials were reviewing his job performance. The state’s online enrollment system wasn’t ready to launch on schedule and has had technical problems.
Bob Laszewski, a health care industry consultant, said Americans may be more familiar with the problems of the federal health insurance website, HealthCare.gov, but state exchanges are “startlingly short of their expectations” for enrolling people and “no one is doing really well.”
Laszewski said he and others believed that Maryland was going to be an example of a well-run exchange because it had a supportive state government that started early. The state was also transparent about the setup process and was reporting doing testing during the summer, he said.
“And then they launched and fell flat on their face,” he said of the website’s October rollout.
A bottleneck developed when the website couldn’t handle the volume of people trying to create accounts all at once, and the glitches have continued. As of Nov. 30, a total of 3,758 individuals had enrolled in private plans through the site. That’s less than 3 percent of the 150,000 people the state expected to enroll in qualified health plans during the first year.
Joel Ario, who oversaw initial planning for the insurance marketplaces in the Obama administration and is now a top consultant with Manatt Health Solutions, knows the former leaders of both the Maryland and Oregon exchanges and said he doesn’t believe either was the problem. But Ario said that when things don’t go well “the people at the top have some accountability.” He said part of the trouble with the Maryland exchange may be that the state had a more elaborate plan for its website when it could have started with a slimmed-down plan that just met the basic requirements.
Pearce’s departure as the executive director of the Maryland Health Benefit Exchange was announced on Dec. 6 by Dr. Joshua Sharfstein, board chairman and secretary of the Maryland Department of Health and Mental Hygiene. The exchange is responsible for the administration of the state’s health exchange website, MarylandHealthConnection.gov.
Sharfstein declined a request for an interview this past Saturday, and telephone messages left for Pearce last Saturday were not returned. A spokesman for Lt. Gov. Anthony Brown, who was tasked by Maryland Gov. Martin O’Malley with leading the Democratic administration’s effort to implement health care reform, also did not return repeated messages Saturday.
Pearce, who was appointed to the job in 2011 and previously worked at Kaiser Permanente, was criticized for taking a vacation to the Cayman Islands during Thanksgiving week while repairs to the site continued. She was not checking e-mail or voicemail while on vacation, a spokeswoman for the board, Dori Henry, confirmed. The vacation was first reported by the Baltimore Sun.
Carolyn Quattrocki, who leads the Maryland Governor’s Office of Health Care Reform, has been appointed to take over as the interim executive director of Maryland’s exchange.