By Carla Anderson
April 4, 2014
March 31 was the last day to apply in Maryland for private health insurance coverage for 2014. However, consumers who started applications on the Maryland Health Connection website or registered through the call center by March 31 have until April 18 to complete their applications. Details about the extension are available on the website.
Enrollment for Medicaid or CHIP continues throughout the year.
Individuals who remain uninsured after March may face a tax penalty of $95 or one percent of income, whichever is greater.
Maryland Health Connection has experienced numerous challenges including technical problems, legal disputes, the executive director’s resignation, and more.
Severe technical problems have plagued the Maryland Health Connection website. Some consumers who were unable to sign up for private insurance were temporarily enrolled in the state’s high-risk insurance program, at the state’s expense. Problems with determining who qualifies for Medicaid means the state is may make about $20 million in unnecessary payments over two years. Maryland fired its prime contractor, Noridian Healthcare Solutions, and announced it will adopt the successful technology used by Connecticut’s marketplace, Access Health CT. The state has not ruled out legal action against Noridian, and Noridian and another vendor are fighting each other in court. U.S. Rep. Andy Harris has asked the federal government to investigate how Maryland spent grant money to develop and fix its website.
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. Work on the SHOP website was put on hold in February, and the launch date pushed back until Jan. 1, 2015. As of April, small businesses can purchase policies and receive tax credits by working directly with insurers or through brokers or third-party administrators (TPAs). Thirteen insurers are selling small-business plans.
Officials were embarrassed by the revelation that they have been citing incorrect enrollment targets. Maryland officials repeatedly referenced an enrollment target of 260,000. However the Hilltop Institute, which developed the estimate, reported that it incorrectly included the first and second open enrollment periods in the 260,000 figure. The corrected estimate for the Oct. 1, 2013, to March 31, 2014, enrollment period is 160,000 in either private health plans or Medicaid.
Despite all of the problems, Maryland exceeded its enrollment goal (even the higher, incorrectly reported target). As of March 22, nearly 270,000 Marylanders obtained health insurance coverage: 49,293 enrolled in private health plans and 220,043 qualified for Medicaid or the Children’s Health Insurance Program (CHIP).
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.
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.
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