UPDATED 3/18: Which state health insurance exchanges are failing?

Published: March 18, 2014

Health CareSoftware

Most of the national discussion regarding health insurance exchanges (HIXs) has centered on the federal exchange. However, most of the state exchanges have faced varying amounts of technical difficulties. The chart below provides the status of each exchange based on Deltek research over the last two weeks. For more information on the trends behind the state HIX market, see Deltek's latest report. The latest updates to the chart below are marked with an asterisk (*).

State Site Status Notes
California* Operational The site was recently down for five days, but the problem was ascribed to a maintenance malfunction rather than a systemic flaw.  A security flaw was fixed relating to the exchange's access to central federal databases.  The site has passed the 1 million enrollment mark.
Colorado* Operational No publicly reported issues.  The exchange has the fourth highest enromment rate among state-operated exchanges.
Connecticut* Operational As of 2/24, the site was in good enough order that the exchange operator was considering becoming an application service provider (ASP) to other states.  Maryland is considering adopting this exchange to replace its failed implementation.
District of Columbia* Operational The District dealt with "hundreds" of problem applications and other minor technical glitches during rollout.  Enrollment figures for this exchange are significantly below the target figure, but it is unclear as to what extent technical problems are to blame.  The exchange recently extended the agreement with its contractor for follow-on work.
Hawaii* Failing The site has remained plagued with difficulities that might prevent the non-profit entity that oversees it from achieving sustainable funding.  The state might have to take over the exchange in order to maintain operations.  Exchange CEO quit during rollout.
Kentucky* Operational No publicly reported issues.
Maryland* Failing Maryland is considering adopting Connecticut's exchange to replace its failed implementation.  A recent report detailed the costs of the exchange.  U.S. HHS's Inspector General will be investigating the exchange.
Massachusetts* Failing Problems during rollout were so severe that the state opted to turn off certain backend software functionality and perform manual workarounds to enroll citizens.  The state has fired its contractor and will seek another extension to the federal enrollment deadline.
Minnesota* In remediation Severe enrollment backlogs continue and the state was slow to address call center capacity.  Manual workarounds are the backbone of the system for now.  The state may seek a new contractor.
Nevada* Failing Insurers, brokers, and service providers have found the site unusable.  Publicity has become so bad that the governor has had to personally pressure the contractor for action.  Consultants have been hired to help develop a remediation plan before the 2015 open-enrollment period begins.  The exchange CEO quit in February.
New York* Operational The site was overwhelmed in December, but no other issues have been publicly reported.  The site is experiencing a last-minute enrollment surge.
Oregon* Failing The state has considered a host of political and technical fixes to the exchange in an effort to salvage the system, but it is not expected to be operating before the enrollment deadline.  U.S. GAO will be investigating this exchange.
Rhode Island* Operational No publicly reported issues.  The state is providing a social media tool for parents to nag their children into signing up for insurance via the exchange.
Vermont* Failing The site has suffered from several failings since its launch with the latest being the failure of the payment engine for small businesses seeking to acquire insurance for employees.  The state halted funding to its contractor in late December until fixes are completed.  Online payment has been added to the site, but fundamental operational failures linger.
Washington* In remediation The site was down in early December.  Officials claim that the state is still working on the website and call center, which are both open for business.  Thousands of enrollees have been stuck in the exchange, but it is operating.

Source: Deltek (as of March 18, 2014)

Updates:

  • 2/4: NV downgraded from "Operational" to "Failing"
  • 2/4: Updated info for MN
  • 2/25: CT upgraded from "In remediation" to "Operational"
  • 2/25: Updated info for CA and MD
  • 3/18: Updated info for all states.
  • 3/18: DC upgraded from "In remediation" to "Operational"
  • 3/18: WV (partnership exchange) removed from table.