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Health

Deadline Tuesday for retroactive health coverage

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With a deadline Tuesday for uninsured Marylanders to secure health coverage retroactive to Jan. 1, would-be enrollees continued to report frustration with the state's troubled health exchange.

Matthew Silverglate, a 29-year-old server and bartender from Ellicott City, said Monday he had been calling and logging on to the Maryland Health Benefit Exchange for two months, and still had not been able to price out a private health plan.

Dr. Peter Beilenson, who heads an insurance cooperative that sells coverage on the exchange, said he made four separate calls last week, using four different names, to try to get an appointment with a plan navigator. By Monday, he said, none of his aliases had received a call back.

With the number of Marylanders still stuck in health exchange limbo estimated in the thousands, lawmakers in Annapolis are considering emergency legislation to expand eligibility for a state-administered plan that was supposed to be phased out after the Affordable Care Act took effect.

State officials, meanwhile, were urging the uninsured to call 1-800-396-1961 by 5 p.m. Tuesday, which they said would ensure that they can buy a plan that will cover health expenses going back to the start of the year. Officials worked out the retroactive coverage with the insurance companies a week ago.

It remains unclear when Marylanders who have been stymied by technical glitches with the website and call center will be able to buy their insurance. As of Sunday, 458 households had registered for retroactive coverage, a spokeswoman for the exchange said.

Spokeswoman Dori Henry said state leaders understand the frustration of those who still haven't been able to get insurance.

"That is why the governor and lieutenant governor and the leadership of the exchange have been working to expand options, including the retroactive option and introducing the [Maryland Health Insurance Plan] bill," she said. "Those are all efforts to ensure that people who want coverage can get coverage."

Computer problems have dogged the exchange since open enrollment began Oct. 1. Most recently, the website listed a telephone number that sent callers to a pottery business in Seattle, and a programming error led Medicaid enrollment packets for as many as 1,078 customers to be mailed to wrong addresses.

About 22,500 Marylanders had purchased private health plans through the exchange as of Jan. 11, officials reported last week. Another 29,500 had signed up for Medicaid, and 93,500 were shifted from a bare-bones state program to Medicaid.

Before open enrollment began in October, officials expected 260,000 to get coverage by March 31. That's when the enrollment period ends for the year, and people without insurance will face a tax penalty.

Maryland is home to an estimated 800,000 uninsured. Of these, about half are not legal residents and do not qualify for coverage.

Silverglate said he does not get health insurance from his restaurant job in Ellicott City, but he is covered through February under insurance from a previous employer. Then he'll be on his own.

Silverglate said he suffers from a sometimes debilitating case of Crohn's disease. He said exchange workers have told him he is eligible for a subsidy to help pay for a private plan. But the exchange's computer system has not worked the break into the price, leaving him unable to make a purchase.

"I've been trying almost every day, dozens and dozens of phone calls," he said. "My case has been escalated eight or nine times — I stopped keeping track."

Silverglate said exchange workers have assured him repeatedly that his information is in order, the computer will reset his account and he can buy his plan.

Still, nothing. The latest glitch: The exchange computer has decided that he is Native American and wants to know his tribal affiliation, he said.

Silverglate is Jewish.

"I've pulled my hair out," he said. "I always thought that was just an expression. Apparently it's not. It's an actual thing people do."

Beilenson heads the Evergreen Health Co-Op, one of four groups selling insurance on the state exchange.

When he made his test calls last week, he said, he was told to expect a call back in three to five days. He said he has yet to receive one. He expects them to come after Tuesday's deadline passes.

"Obviously," he said, the process "is not fully functional. And for the individual to try to do it themselves, it is very, very difficult."

Before state officials persuaded insurers to offer retroactive coverage in private plans, Gov. Martin O'Malley pitched emergency legislation that would let people stymied by the exchange's glitches join the state's high-risk insurance pool, the Maryland Health Insurance Plan, known by its acronym, MHIP.

State lawmakers were scheduled to vote on that stopgap plan this week, with extended debate on its merits and price — which could be as much as $10 million — expected Tuesday.

Officials estimate that as many as 5,000 Marylanders tried to get insurance through the exchange before Jan. 1 but got stuck in the website's problems. For those who do not sign up for private coverage by the deadline today, MHIP could be another option.

Debate began in the Maryland Senate Monday night on the bill, which would reopen enrollment in MHIP and extend the life of the program to keep people insured. The Senate passed the measure, 38-8, Tuesday morning. It goes next to the House of Delegates, where it requires a three-fifths majority.

Senator Thomas "Mac" Middleton, a Charles County Democrat and chair of the Finance Committee, urged his colleagues to support the legislation for people who did not get private insurance before Tuesday's deadline.

"If there's one person or 10 people out there who didn't do it, this is the safety net," Middleton, a Charles County Democrat, said Monday. "There's been an all-out effort to get those people informed so that they can get into the exchange."

Senate Minority Leader David Brinkely said the Republican caucus has a lot of questions about the MHIP plan, particularly its costs, but he supports the legislation to make sure people who want health insurance can get it.

"These people have been harmed," Brinkley said. "These people tried to get insurance, and they didn't do anything wrong. It was government malpractice."

Baltimore Sun reporter Meredith Cohn contributed to this article.

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