High-level officials are urging Maryland Gov. Martin O’Malley (D) to stick with Maryland’s problem-laden health exchange instead of dropping it in favor of the federal system.

Switching, these officials say, might create even more problems.

Chet Burrell, president and chief executive of the Maryland-based CareFirst BlueCross BlueShield, told O’Malley in a letter that moving to the federal exchange could result in “substantial new risks and costs” that could further complicate problems. CareFirst is one of the insurance carriers participating in Maryland’s exchange.

“All things considered, my strong advice would be that the State stay its course and fix as much as it can with its own Exchange during this current open enrollment period,” Burrell wrote to O’Malley on Friday. “While far from perfect, I believe this is the most stable and effective course and is mostly likely to lead to the enrollment of the greatest number of people possible which I know to be your interest.”

The letter was obtained by The Washington Post. The open enrollment period to which Burrell refers runs through the end of March.

Burrell wrote that CareFirst has been dealing directly with the federal exchange in Virginia and has found that “there are many serious and persistent operating and technical issues that undermine effective enrollment” in that program as well, including not being able to correct and maintain life-event changes for people once they enroll.

“We are concerned about the confusion, poor service and anger this will produce,” Burrell wrote.

The letter was part of a continuing discussion that Burrell has had with the governor, and the CEO wrote that CareFirst is happy to advise the state moving forward. CareFirst spokesmen did not dispute the authenticity of the letter late Monday and released a statement reiterating that it “would be ill-advised to change technology and processes in mid-stream.”

Sen. Barbara A. Mikulski (D-Md.) said Friday that even though the rollout of Maryland’s program has been a “disastrous, dysfunctional situation,” the state should stick with its exchange and work to improve it.

“I think Maryland is really getting its act together and is on the right track,” Mikulski said after a news conference at Mercy Medical Center in Baltimore. “The federal exchange is a work in progress, so to move from one system that has had a creaky start to another system that has had a creaky start — I don’t think is advantageous to Maryland.”

But the senator said that she understands the frustrations of Rep. John K. Delaney (D-Md.), who has repeatedly called for Maryland officials to assess a move to the federal health-care exchange. This month, Delaney sent a letter to Maryland’s secretary of health seeking a brief analysis of the pros and cons of switching to the federal exchange, perhaps even temporarily.

“With less than three months remaining in the open enrollment period, each day is critical,” Delaney wrote on Jan. 6. “It is important to understand if we have viable alternatives or if the best course of action remains a reboot of the existing product.”

Fellow Democrats and some Republicans in Annapolis have echoed Delaney’s call. Gubernatorial hopeful Del. Heather R. Mizeur (D-Montgomery) called Maryland’s performance “among the worst in the country” and said state officials need to consider redirecting Marylanders in need of health insurance to the federal marketplace.

Neither O’Malley nor Lt. Gov. Anthony G. Brown (D), the gubernatorial front-runner and the official in charge of implementing President Obama's Affordable Care Act in Maryland, has ruled out a move to the federal exchange.

But their comments in recent days have made clear that it’s not likely to happen.

“The problem is, there was no assurance at that time that the federal Web site was going to work any better . . . and it didn’t,” O’Malley said Sunday morning as the lead guest on CNN’s “State of the Union.”

“Right now, in fact, our Web site is working a lot better for the majority of our citizens who are signing up for Medicaid than the federal site is.”