Health Fix

December 19, 2013
BY Marc Shapiro
With signup deadlines approaching, Gov. O’Malley and Lt. Gov. Brown are working to boost enrollment and fix Maryland’s health-care website
Lt. Gov. Anthony Brown says the O’Malley administration is moving  forward with all hands on deck to fix the state’s health-care website  and enroll more Marylanders in insurance plans. (Marc Shapiro)

Lt. Gov. Anthony Brown says the O’Malley administration is moving forward with all hands on deck to fix the state’s health-care website and enroll more Marylanders in insurance plans. (Marc Shapiro)

State officials say fixing Maryland’s flawed heath-care website and increasing enrollment is their No. 1 priority.

“I am frustrated and disappointed with how the launch of the website has gone,” Lt. Gov. Anthony Brown said at a recent news conference.

He and Gov. Martin O’Malley announced a variety of steps Monday to boost enrollment and fix the site. Brown also promised an investigation into what went wrong with the site launch “once the exchange is running at full capacity.”

“The decision to launch was a good one notwithstanding that the launch was not a success,” Brown said.

O’Malley and Brown announced Tuesday that the deadline for Marylanders to enroll in health-care coverage under the Affordable Care Act in order to have coverage on Jan. 1 has been extended to Dec. 27. Open enrollment lasts until March 31, 2014.

Carolyn Quattrocki, executive director of the governor’s Office of Health Care Reform, was named interim director of the Maryland Health Benefit Exchange (MHBE). Her appointment comes after Rebecca Pearce resigned on Dec. 6; she was facing questions about taking a vacation to the Cayman Islands while there were technical issues with the website.

Two other states, Hawaii and Oregon, have had to replace their state exchange heads amid technical issues.

The MHBE brought in Columbia-based Optum/QSSI, a health-care IT company and general contractor that the government hired to improve HealthCare.gov, the federal exchange.

Isabel FitzGerald, secretary of the Maryland Department of Information Technology, is leading the IT effort and has since addressed nine technical issues O’Malley outlined in time for the mid-December deadline the governor promised.

At a news conference on Dec. 10, Brown reported that nearly 22,000 Maryland residents were on track to obtain coverage, 5,200 having enrolled in private insurance plans and 17,000 in Medicaid. That week, the state experienced its highest enrollment numbers, with 1,400 private insurance enrollments and 3,200 Medicaid enrollments.

The first weekend in December, the exchange converted 87,000 people enrolled in the state’s Primary Adult Care program for low-income uninsured adults without children to Medicaid.

Brown said the state’s original goal of enrolling 150,000 people in private insurance plans by the March deadline remains. Maryland’s uninsured population is estimated to be 800,000 people, about 14 percent of its 5.8 million residents.

Larry Burgee, chair and associate professor at Stevenson University’s Department of Information Systems, said regardless of the technical issues and fixes, people have lost trust in the website.

“People are worried they’re going to put all this personal information in and it’s going to get lost in the vacuum somewhere,” he said. “If you don’t establish trust up front … people are going to run for the hills and run for the competition, and unfortunately here, there’s no competition.”

Laslo Boyd, managing partner at Mellenbrook Policy Advisors and a political columnist, said the technical glitches, while disheartening to those seeking insurance, might not permanently turn people off.

“People who are discouraged [now] but discover the website is working easily have every incentive to come back to it,” he said.

To increase enrollment, Brown announced additional call center hours and outreach to those who have begun the application process but not completed it through emails, regular mail and robocalls, in addition to the December deadline extension.

Burgee said the push now needs to be on a non-political marketing effort, as well as addressing the technical issues.

“You’ve got to get people to buy back into it,” Burgee said. “Everybody keeps being told that all the stuff is going to be better, and yet, you had a lot of people who weren’t complaining about [insurance] they had.”

The extra resources follow a variety of issues that preceded and followed the launch.

Two carriers, Aetna and a subsidiary, Coventry Health, withdrew from the exchange in August when rates were set to be lower than what Aetna requested.

When the site launched on Oct. 1, Marylanders looking to sign up for insurance found a slow website, had trouble enrolling in plans and were dismayed at the amount of personal information they had to enter in order to get quotes.

Brown said he had indications that there would be problems with volume, as well as unique cases such as Native American families and larger families seeking insurance, but those problems were “nothing that amounted to what we saw on Oct. 1,” he said.

Marylanders were dealt another blow in November when the Maryland Insurance Administration was notified by carriers that 73,000 residents will lose their current insurance plans due to new federal requirements for comprehensive coverage.

While President Barack Obama promised a one-year extension on plans that were to be dropped, experts say he and Congress might not have the power to enforce that, and it is mostly in the hands of the insurance companies.

Experts such as Burgee hope the website gets fixed, and uninsured Marylanders get the coverage they need, but they aren’t feeling optimistic about the numbers.

“I really hope it works, but I am very skeptical,” Burgee said.

Marc Shapiro is a JT staff reporter
mshapiro@jewishtimes.com

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