Trying to help thousands of Maryland residents who still can't enroll online, lawmakers are hoping to use the state's high risk pool plan as an emergency, short-term coverage option, while the insurance exchange's problems are fixed.
Under a bill designed by Governor Martin O'Malley's administration, the Maryland Health Insurance Plan Fund, the state's high risk pool plan, would be extended and "used to subsidize health insurance coverage for bridge eligible individuals," those who qualify for exchange credits but were "unsuccessful in enrolling in coverage."
The coverage would be retroactive to Jan. 1, and would end when Marylanders enroll in an exchange plan. The bill also states that the program could extend to as far in the future as 2020, as sort of a safety net for continuity of coverage.
The new proposal comes amid increased frustration with the management of Maryland Health Connection, the state insurance exchange, and lingering problems for consumers unable to complete enrollment.
According to Maryland Health Connection, more than 18,000 Marylanders have enrolled in qualified health plans as of Dec. 28, although its not clear how many have successfully made initial premium payments. Consumers across the state have reported varying problems and setbacks throughout the process.
"After three 'escalations' I can now theoretically sign up at MD Health Connection, but the site isn't responding," Miriam Tucker, a Maryland-based freelance writer living with type 1 diabetes, Tweeted on Dec. 16, before being able to complete the process a few days later.
On Dec. 26, she followed up and had to give the HIX a sort of nudge: "I just now had to ask MD Health Connection to send my info to Carefirst. It hadn't been sent automatically."
With various glitches and contractor disagreements in the first few months, Maryland Health Connection is hoping to recover with fresh leadership after Maryland Health Benefits Exchange director Rebecca Pearce stepped down. And they may end up getting more nudges from the governor and legislature.
Ahead of an election for governor, Democratic and Republican candidates have been offering critiques of the "debacle," as one candidate put it; one is proposing that the state shutdown Maryland Health Connect and have consumers use Healthcare.gov.
In slightly related news, the O'Malley administration has secured a waiver with the federal government that is in some ways historic: the government is going to try to cap all public and private health spending growth.
As part of a what's being billed as modernization to Maryland's all-payer rate system, the state will try to keep its rate of hospital spending growth to no more than state GDP, one of a few states to take on such a challenge. Massachusetts is trying to keep the rate of growth for all of its healthcare spending in line with its economic growth.