Cal­i­for­nia is seen as the shin­ing star among the 13 exchanges, but that may be damn­ing with faint praise, giv­en the sham­bles some of the states made of the entire Afford­able Care roll­out. In Ore­gon, they are decid­ing whether to give up and go fed­er­al or hir­ing a new con­trac­tor to fix the tech­nol­o­gy. In Mass­a­chu­setts, they admit there is a lot of work to be done for the next roll­out this fall and the gov­er­nor is busi­ly tem­per­ing expec­ta­tions. Cal­i­for­nia still comes under scruti­ny, not because of the sys­tem, but because they have found it nec­es­sary to nar­row the provider net­works. They have extend­ed dead­lines for enroll­ment in Wash­ing­ton, and Ver­mont may get an over­haul. As for Mary­land, call an MD.