Md. Senate committee seeks more documents, second hearing on health exchange problems

The chairman of the Maryland Senate Finance Committee has asked state officials to provide updates on the status of the the state’s health exchange every two weeks, after expressing frustration that he had not bein informed in advance of brewing problems with the program.

Sen. Thomas M. Middleton (D-Charles) also asked Joshua M. Sharfstein, secretary of health and mental hygiene, to appear before the committee for a second time to answer questions about what went wrong in the rollout of the state’s health-exchange Web site. That briefing was scheduled for Friday, but then was postponed for at least two weeks so the committee can gather and review documents related to the exchange.

Sharfstein addressed the committee for more than an hour on Tuesday and provided members with more than 70 pages of documents, including executive summaries of monthly reports from an independent auditor, letters to and from health officials and slides from a presentation explaining how Maryland picked a contractor to build its site.

Middleton said he asked Sharfstein on Wednesday night to provide the committee with all documents related to the exchange that have been released through public information requests.

He also requested the fully monthly reports from the auditor, up to the time of the site’s launch in October.

Middleton said that the Attorney General’s Office will have to review those reports, about 1,000 pages in all, and redact any sensitive information before they are released to the committee.

That process is estimated to take about two weeks, he said. The goal of the committee is to eventually post as many of these documents as possible online.

“When you start to get into super sensitive stuff... you have to handle it carefully,” Middleton said. “I wouldn’t want a system that we’ve spent millions of dollars on to be compromised.”

Middleton said that once the information is collected, the committee will schedule another briefing to discuss it.

“It’s going to take a long time to go through the information,” Middleton said, adding that he hopes to soon resolve questions about the exchange and move on. “I understand people’s curiosity, their need to know, and I understand the politics of it.

At the first briefing, earlier this week, Middleton said that state officials should have told top legislators about potential problems with the site before its launch.

“I got assurance that everybody was going to be going in the same direction... and that we were going to get this thing fixed,” Middleton said. “I asked the question before the kickoff, ‘Are we ready?’ and we were told, ‘Yes, it is ready. Come October 1, the systems are ready to go.’ And that didn’t happen.”

That comment came as Lt. Gov. Anthony G. Brown (D) sat before the committee on Tuesday. Brown largely focused his testimony on emergency legislation that would provide retroactive health insurance to residents lacking coverage because of the faulty exchange, but he also addressed some general questions. Brown, who is running for governor, is in charge of implementing President Obama’s Affordable Care Act in Maryland.

Maryland officials were among the earliest and most enthusiastic supporters of the federal health-care law, and Maryland was one of 14 states that chose to run its own health insurance marketplace. But the site crashed the first day and has had ongoing problems that have stymied an unknown number of Marylanders who have tried to sign up for coverage.

Middleton said that he read a report in The Washington Post that detailed the many warnings that state officials received over the course of more than a year about serious problems in the $170 million project.

The Post reviewed thousands of pages of previously undisclosed documents, including e-mails, internal reports, audits and court records, along with dozens of interviews. Among the documents was a November 2012 six-page letter from the state’s director of policy analysis to top legislative leaders that laid out the “significant identifiable risks” associated with developing the exchange, especially in such a short timeframe.

There was also a consultant’s report from December 2012 that warned that the “staff sizing is very lean for a project of this size and complexity,” that there was not a detailed project plan, and that “inefficient communication between the project teams ... could have a negative impact.” The report also said that the state did not appear to be leaving itself with enough time to “complete, verify and test all system components before go-live.”

Those documents were not included in the packet Sharfstein gave to committee members. A spokeswoman said that Sharfstein only included documents that were relevant to his initial briefing and that the packet of documents was not meant to be “comprehensive.”

Middleton said that even though he is a member of the Maryland Health Care Reform Coordinating Council — co-chaired by Brown and Sharfstein — he did not know that an independent auditor that was generating monthly reports. At the “very minimum,” he said those reports should have been shared with presiding officers, if not also with committee leaders.

“I had no idea,” Middleton said. “I had no idea that these reports were coming in that seemed to spell out that there was disaster waiting.”

Sharfstein encouraged Middleton and others to read the monthly reports for themselves. He said that “it’s a little more difficult” to discern how dire the problems were than was characterized by reporters who “plucked out different parts of it.” In addition to warnings of risk, Sharfstein said they also received “very positive assessments from different sources.”

“When you look at it all... it’s not crystal clear,” Sharfstein said.

Middleton said that Sharfstein has always been “very faithful” at giving him a heads-up about issues so that he’s not surprised when he reads the newspaper. He wondered why that wasn’t true ahead of the exchange’s launch.

“Frankly,” Sharfstein said, “I would have called you had I thought that this project was in this kind of grave danger. I would have called you, just as I would have called the lieutenant governor and the governor. ...For a number of different reasons, we missed it.”

John Wagner contributed to this report.

Jenna Johnson writes about Maryland politics, including the General Assembly, the administration of Gov. Martin O'Malley and the 2014 election.
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