Joshua Sharfstein (left), secretary of the State of Maryland Department of Health and Mental Hygiene, testifies on state exchanges and Medicaid expansion. (Photo: Chris Maddaloni/CQ Roll Call/Newscom)

Joshua Sharfstein (left), secretary of the State of Maryland Department of Health and Mental Hygiene, testifies on state exchanges and Medicaid expansion. (Photo: Chris Maddaloni/CQ Roll Call/Newscom)

Six heads of state exchanges established under the Affordable Care Act, or Obamacare, defended their often poor-performing online insurance marketplaces yesterday on Capitol Hill.

Appearing before a House Oversight and Government Reform Committee hearing, state leaders for Obamacare insurance exchanges in Maryland, Massachusetts, Hawaii, Minnesota, Oregon, and California were grilled by lawmakers about glitch-ridden websites, pre-checked voter registration cards, enrollment goal estimates, and education outreach.

“No one is trying to push back and say you’re not working hard or you’re not trying to make something work,” said Rep. James Lankford (R–Okla.) to the exchange leaders at the end of the marathon hearing. “The frustration is obviously this is a round peg in a square hole at times and trying to work through federal regulations and what you already have in your state.”

Democratic committee members argued the hearing, the 26th to examine Obamacare’s shortcomings, distracted from efforts to fix the law, which also experienced a botched rollout of its own federal insurance exchange website, HealthCare.gov.

“It has not always been pretty but we should take a moment to reflect on what we have accomplished,” said Ranking Member Elijah Cummings (D–Md.).

Among the more contentious back-and-forth exchanges, Rep. Jim Jordan (R–Ohio) challenged Dr. Joshua Sharfstein, Chairman of the Maryland Health Benefit Exchange board, as to why Maryland, in February, lowered its expected enrollment in the state-based insurance exchange.

While the Centers for Medicare and Medicaid Services had projected that Maryland would enroll 150,000 residents in insurance plans through the exchange by the enrollment deadline of March 31, state officials said that goal was inaccurate, pointing to an independent study by The Hilltop Institute, a Baltimore-based health research organization, that said the state would instead reach 70,000 during the first enrollment period.

“That was an estimate, never a goal,” Sharfstein said of the CMS projection. “And it was an estimate error.”

Rep. Ron DeSantis (R–Fla.) pressed Peter Lee, executive director of California Health Insurance Exchange, about Covered California recently sending an unidentified California couple a voter registration envelope pre-marked with an “x” next to Democratic Party. “It’s being investigated” Lee confirmed.

All six of the exchanges represented at the hearing have faced technological and other enrollment problems in their online insurance marketplaces, with states like Oregon failing to sign up a single applicant completely through its site. This week, Maryland’s exchange board voted to scrap its $125.5 million site and replace it with technology used by Connecticut’s Obamacare exchange. That swap could cost taxpayers $40 million to $50 million.