By Carla Anderson
February 13, 2014
The consumer and political outcry over the malfunctioning Maryland Health Connection continues. Consumers are complaining on social networking sites, the Legislature is considering whether to fix the system or scrap it and start over, and Democratic candidates for governor are sharply criticizing the administration of fellow Democrat Gov. O’Malley.
O’Malley and Lt. Gov. Anthony G. Brown, who is the administration’s point person for the marketplace and also a gubernatorial candidate, pushed emergency legislation to help consumers who weren’t able to get coverage by Jan. 1 due to website problems. The measure allows consumers who weren’t able to gain coverage to enroll in the state’s high-risk insurance program. Early estimates suggested up to 5,000 people might be enrolled in the high-risk plan. However, that figure was reduced to several hundred after insurers selling policies through the marketplace agreed to extend the enrollment deadline and make the coverage retroactive to Jan. 1.
Maryland Health Connection has experienced numerous challenges. Consumers have faced technical problems with the website, including difficulties setting up accounts, learning if they qualify for subsidies, and seeing all the available health plans. In addition, the Maryland Health Benefit exchange, which oversees the marketplace, has repeatedly delayed the launch of the Small Business Health Options Program (SHOP), which will be used by small businesses. The launch of the SHOP website is now set for Jan. 1, 2015. Beginning in April, small businesses can purchase policies and receive tax credits by working directly with insurers or through brokers or third-party administrators (TPAs). High-level personnel problems and legal disputes between contractors have also caused trouble for the Maryland Health Connection.
Maryland was an early adopter of the health insurance marketplace envisioned by the Affordable Care Act (ACA). While many other states waited to see the outcome of the Supreme Court challenge to the ACA, Maryland moved ahead. The Maryland Health Benefit Exchange (MHBE) was signed into law in April 2011, with additional legislation passed in May 2012. The MHBE was later rebranded as the Maryland Health Connection. In December 2012, the Maryland Health Connection was among the first six state-based exchanges to be approved by the federal government.
Maryland Health Connection is overseen by a nine-member board. The board has been driving decisions on the state’s exchange since 2011.
Maryland Health Connection functions as a clearinghouse, meaning any qualified health plan (QHP) can sell policies on the exchange. Any health plan with significant market share in the state is required to participate in the marketplace. After two years of operation, the exchange has the option to adopt an active purchaser model. Health plans are limited to selling four benefit packages per metal level (platinum, gold, silver, and bronze).
Maryland’s Connector Program provides in-person education and help with enrollment. Six organizations were selected to provide regional “navigator” — or outreach — services:
According to Kaiser’s statehealthfacts.org, about 770,000 Marylanders are uninsured. About 150,000 individuals are expected to purchase health insurance through the Health Connection in 2014, and the state estimates the exchange will save it $850 million over 10 years through lower costs for Medicaid and uncompensated emergency room visits.
Through the end of January, about 29,000 Maryland residents enrolled in private health plans and about 81,000 have qualified for Medicaid or the Children’s Health Insurance Program (CHIP).
Maryland Health Connection
Maryland Health Benefit Exchange (MHBE)
Information about exchange planning and development
State Exchange Profile: Maryland
The Henry J. Kaiser Family Foundation overview of Maryland’s progress toward creating a state health insurance exchange.
Health Education and Advocacy Unit, Office of the Attorney General
Serves residents and other consumers who receive health care from a Maryland health care provider or health insurance provider.
Let your Maryland governor and legislators know how you feel about the state’s proposed health insurance exchange.Maryland Governor Martin O'Malley