State-run exchanges that have struggled to enroll residents know they’re in dire straits when they need to ask federal regulators for help fixing technical glitches following the debacle.

“Some states have been encouraged by the improvements we’ve seen in the federal site over the last few months, and I suspect they want to leverage some help from the folks that have saved the day for the federal exchange,” observes Don Garlitz, executive director of bswift Exchange Solutions, which has assisted Connecticut’s SHOP exchange. He reports that the Access Health CT public exchange, considered a rare bright spot along the state-run HIX horizon, has been looking to help other states. 

The issue was significant enough to spark talk of extending the 2014 HIX open enrollment deadline beyond March 31 in states where residents could not complete applications through their respective online marketplaces.

U.S. Department of Health and Human Services Secretary Kathleen Sebelius testified during a recent congressional hearing that special enrollment periods could be allowed for consumers whose applications stalled because of technical glitches. But she stopped short of green-lighting state-run HIX extensions, which at least one industry observer cautioned as a directive that could appear to validate procrastination.

States that have sought more time for their residents to enroll in their own HIXs include Oregon, which applied for a federal waiver to extend enrollment through April, as well as Washington, Nevada, Kentucky, Vermont and Maryland. Massachusetts has gone as far as seeking an extension through September that would let residents hold onto their current coverage or enroll in temporary plans, according to Modern Healthcare.

While it remains to be seen whether enrollment extensions will be granted in some states, all the technical troubles convinced HHS to reverse its longstanding insistence that federal subsidies be available only through public exchanges.

Americans who attempted, but failed, to sign up through their state-run exchange because of technical problems may still receive retroactively applied financial assistance. HHS will allow the arrangement as long as individuals purchase an off-exchange private insurance policy that complies with the Affordable Care Act.

The change of policy fueled a political firestorm, with U.S. Rep. Joe Pitts (R-Pa.), who chairs the Energy and Commerce subcommittee on health blasting the Obama administration for “blatantly ignoring the law.” The move, however, was seen as necessary to avoid “a huge potential legal liability,” Sara Rosenbaum, a professor of health law and policy at George Washington University, recently told The New York Times.

John Kitzhaber, Oregon’s Democratic governor, had asked that the federal government make assistance available to residents of his state who ended up buying insurance from a source other than the Cover Oregon HIX. He recently left open the possibility that the state could tap the federal portal to enroll its residents in the online marketplace.

Despite spending more than $150 million on outside contractors such as Oracle to build its Web site, Cover Oregon has been unable to process online enrollments and is widely considered one of the worst state-run public exchanges.

Despite technical glitches in the public HIX marketplace, bswift’s Garlitz believes this model will continue to interest employers for two reasons. One is that it may make more sense over time to steer some part-time employees and those who become COBRA eligible into public exchanges. He says the other is that “the ongoing interest on the part of carriers in private exchanges will be influenced by the successes and failures of public exchanges.”

Shutan is a Los Angeles freelance writer

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