AP Photo/Brian Witte-In this Dec 10, 2013 file photo, Lt. Gov. Anthony Brown, center, talks about problems with Marylands health care exchange in Baltimore. Joshua Sharfstein, Marylands health secretary, is standing to the right, and Carolyn Quattrocki, the interim director of the exchange, is standing to the left. With the open enrollment deadline approaching, some states running their own health insurance exchanges are focused less on getting robust sign-ups than on avoiding total disaster. Nevada, Massachusetts, Vermont, Maryland and Oregon are among the states facing severe technical and administrative problems, which have led to firings of top officials and contract cancellations for key software companies.