Maryland stess tests new health exchange to avoid enrollment troubles

Maryland is in the final stages of testing a new health insurance exchange, modeled off of one used in Connecticut. The state hopes to avoid the troubles it encountered with its previous system, one of the most troubled in the country, which was not prepared to handle the volume of traffic coming its way.

During last year’s open enrollment period for the Affordable Care Act, Maryland’s health insurance exchange was one of the most troubled in the country, in part because the system was not prepared to handle the volume of traffic coming its way.

The state is now taking extra measures to ensure that does not happen a second time.

With the next open enrollment period starting on Nov. 15, Maryland officials said IT workers assigned to the exchange will be running hundreds of tests to make sure the marketplace is ready to go, using a system that was successfully deployed in Connecticut.

Isabel FitzGerald, Maryland’s secretary of information technology, said in a presentation Oct. 21 endurance tests will be run on the system to check how it operates under high loads for long periods. She also said the state will be testing how well the system works under complex scenarios, such as for accommodating different needs for different households.


The exchange will ramp up users to several thousand at a time and see how the system handles the stress over six to eight hours. FitzGerald’s team will also be running tests to make sure the system can respond to irregular user requests.  More than 1,700 scenario tests have been completed to date, according to FitzGerald.

In these tests, the IT staffers follow the enrollment process from start to finish based on an imaginary user’s needs. So far, the success rate has been more than 90 percent, FitzGerald said.

Maryland was one of 14 states that developed its own health insurance exchange website as part of the Affordable Care Act rather than take the model offered by the federal government. Those that created their own system saw a range of results, with states like Oregon and Maryland struggling while others like Kentucky and California found great success.

In February, Maryland fired its contractor, Noridian Healthcare Solutions, and brought in the system Deloitte created for Connecticut in April.

Kevin Counihan, the chief executive of Connecticut’s exchange at the time, called Connecticut’s system an “exchange in a box” that could help Maryland replicate his state’s success. Connecticut’s exchange was so successful that the federal government noticed and hired Counihan to run its national model,, which is managed by the Centers for Medicare and Medicaid Services.


Maryland’s original site was fraught with problems from the first day of open enrollment. Architectural problems on the website caused 1,538 defects since going live, FitzGerald said.  Of those, 1,072 have had been successfully resolved when the decision was made to switch exchanges.

The state has budgeted more than $260 million to build the health care exchange, with a large portion of that coming directly from the federal government. The state also was compelled to enact emergency legislation to help insure those who could not sign up and had to begin the year with no coverage.

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