Two weeks ago I received an email from Sameer Parekh Brenn of Boulder containing the following appeal: “My family is being threatened with losing our healthcare coverage because Connect for Health is broken. Would you like to cover the story?”

He went on to say he expected to lose his coverage on June 8. Since I couldn’t get a story into print before then, I called and suggested he attend the Legislative Health Benefit Exchange Implementation Review Committee’s meeting scheduled for Friday, June 5, and tell his story to its members. Mr. Brenn, who had found my name and those of several other reporters through a Google search, thought this was a good suggestion. He promptly emailed Connect for Health to inform them he was speaking with me and planning to testify before the oversight committee. Within a few hours Connect for Health leapt into action, after months of desultory foot dragging.

The tale Sameer related to the committee on Friday morning was sufficiently convoluted to stretch the creative imagination of Kafka. Following the birth of his son in December, an event insured under his wife’s COBRA coverage, he then wanted to add his wife to his own Kaiser plan. In February he was assured that he could make this change, effective March 1 at a rate that was supposed to be $90 a month with premium subsidies. By May 11, after seemingly endless conversations with the Exchange and Kaiser, she had still not been added to his plan. Brenn had been paying for her coverage, however, without a subsidy, in hopes of making sure both mother and baby were covered. They weren’t, although Kaiser sent a bill for another $1,037.96 with a threat to terminate his coverage on June 8 if it hadn’t been paid.

Brenn was bounced like a ping-pong ball between Kaiser and the Exchange, usually after long hours spent on hold. However, once he told them he planned to tell the legislative committee how he’d been treated, the Exchange’s chief information officer, Adele Work, contacted him.

By the time he testified on Friday, Brenn’s case had been resolved. But, as he observed, “You can’t reasonably expect the Exchange’s IT officer to personally fix every appeal. While I’m happy with the outcome in my case, there seems to be something very wrong at the Exchange.”

State Sen. Ellen Roberts, R-Durango, thanked the man for taking the time to confirm the kind of complaints many legislators have been hearing from constituents. A pair of scheduled presentations raised further questions regarding the long-term viability of the Exchange.

Jeff Bontrager, Director of Research on Coverage and Access at the Colorado Health Institute, indicated the troubles at the Exchange run far deeper than bungled customer support. He broke down the options facing the Exchange into two categories: sustainability and exit strategies. Bontrager contended the Exchange could only be sustained if it generates sufficient revenues to cover its operational costs. This will only be achieved if the Exchange can attract a robust risk pool, far larger than its current base of customers, which has proven substantially smaller than originally forecast. Among the recommendations: services provided to Medicaid through the Exchange call center should be reimbursed in some fashion, while technology costs need to fall. The cost and value of “coverage guides” also require scrutiny.

The Independence Institute’s Linda Gorman raised another set of concerns. She estimated that perhaps as few as 7,000 Exchange clients are truly individuals who were entirely without insurance (or “running bare”) prior to Obamacare. The Affordable Care Act’s redefinition of those with sub-standard policies as uninsured distorts the actual impact of the program, she said. While those who had policies cancelled because of their failure to meet minimum coverage standards approached 160,000 Coloradans — and many of these are now happier with their expanded coverage — they were not truly “uninsured.”

Gorman pointed out that for many of the young or the abjectly poor it makes economic sense to refuse insurance. Rather than simplifying enrollment, the ACA application forms are substantially longer than they used to be despite the pre-existing condition exemption. She made the wry observation that salaried bureaucrats who drafted the bill’s provisions, and who can accurately predict their earnings year-to-year, underestimated the vast share of the workforce that sloshes back and forth across the Medicaid eligibility criteria. Establishing this eligibility has proven tedious and expensive. She suggested that making all health care expenditures pre-tax costs for individuals, as they are for employers, would improve system performance. She also took a swipe at the $6 million being paid to the so-called “coverage guides” for what are dubious results.

When Insurance Commissioner Marguerite Salazar appeared to testify, state Rep. Lang Sias, R-Arvada, quizzed her closely regarding the economic health of Colorado’s HealthOP consumer co-op, which has enrolled nearly half of all Exchange clients.

Salazar conceded that HealthOP was “under monthly supervision,” an acknowledgement the enterprise is dipping into its insurance reserves. The federal government provided these moneys on a “one-time,” “front-end only” basis. It is doubtful that most legislators at last week’s hearing recognized how unusual an arrangement this is. With one ACA consumer co-op already having failed, and several others on the brink of bankruptcies, HealthOP has the potential to emerge as a ticking time bomb for the Exchange.

If the U.S. Supreme Court throws out individual eligibility for premium subsidies in states with federally operated exchanges later this month, it should breathe some life into Connect for Health. Otherwise, we may find the Exchange contemplating the wisdom of turning its operations over to the federal government — one of the exit strategies suggested by Bontrager.

Standing just offstage are the advocates of a ‘single payer’, universal health care program for all Coloradans. Advocates are collecting signatures for a measure to appear on the 2016 ballot that was initially suggested by state Sen. Irene Aguilar, D-Denver, a physician. Its chances for success will hinge on whether or not voters have reached a point of health care reform fatigue. Nonetheless, a system collapse for Obamacare could persuade voters it was time to throw the baby out with the bathwater and be done with health care once and for all.

Miller Hudson is a former state legislator and a public affairs consultant. Reach him at mnhwriter@msn.com