O'Malley to push emergency bill to provide retroactive health coverage

The O'Malley administration will propose emergency legislation to provide retroactive health coverage to people who tried to sign up by the end of the year but were stymied by the technical problems that have plagued Maryland's online insurance exchange.

At a briefing Friday by Gov. Martin O'Malley and Lt. Gov. Anthony G. Brown, officials said they hoped to put the bill on the fast track when the General Assembly begins its annual 90-day session Wednesday.

Brown, the administration's point person on implementation of the federal Affordable Care Act, said the bill would allow a few hundred to as many as 5,000 people to receive coverage retroactive to Jan. 1 through the Maryland Health Insurance Plan, a state program created to insure high-risk customers.

He estimated the cost to the state of providing the coverage until those applicants can be enrolled under the Affordable Care Act at $5 million to $10 million.

O'Malley said the state could not provide an exact number of those who tried to enroll but couldn't because of software problems. Brown said the legislation would provide relief for those who "through no fault of their own" could not complete the enrollment process.

Administration officials said the legislation is also expected to extend retroactive coverage to a smaller number who thought they had completed enrollment, but whose sign-ups might be lost in the transfer between the exchange and insurance companies.

The proposal faces likely opposition from Republicans, who have never supported the program known as Obamacare. Del. Nic Kipke of Anne Arundel County, the minority leader in Maryland's House of Delegates, called the emergency proposal "another costly Band-Aid."

"The taxpayer should not be picking up the tab for political cover for the O'Malley-Brown administration," Kipke said.

O'Malley said the state could seek damages from the contractors it hired to set up the health exchange website, but for now, the priority is to fix the system.

"We would hope that the vendors are doing their very best to cure these problems," he said.

Dr. Joshua M. Sharfstein, the state's health secretary and chairman of the exchange board, called the emergency legislation a "backup option" for people who can't get insurance through the exchange until February and will incur bills in January. Once they have private coverage bought on the exchange or directly from an insurer, they won't be eligible for MHIP, he said.

"We're thinking of it as a bridge, an option for certain people who may find they need medical care," Sharfstein said. "The chances are reasonably good it will get through the legislature."

Bradley Herring, a health economist at the Johns Hopkins University and board member of the high-risk insurance plan, said lawmakers still need to work out the details.

"People lost the opportunity to get coverage for January and can't get coverage until at least Feb. 1, so the state is trying to do the best it can to get them something to fill the gap," Herring said. "It would be unreasonable to have insurers on the exchange take them on for January after the fact. MHIP seems to be a vehicle to provide coverage in January."

But Herring said the plan might not help everyone left in limbo on the website — one of the most troubled among the states that set up their own exchanges. MHIP plans can carry deductibles of $1,000 to $1,500 plus co-pays, and the costs might outweigh the benefits for one month or even three months.

The legislature could decide to waive the deductible or allow people to stay in the high-risk pool for months or a year, Herring said.

Leonard Van de Graaff of Baltimore, who has been trying to get a better plan for himself and his wife since November only to run into seemingly endless problems with the website and the call center, said he finally extended his current insurance plan for a month at a higher cost than he would have paid under the exchange. The administration's proposed fix, he said, "doesn't really help me."

O'Malley acknowledged Friday that technical problems with the website have yet to be fully fixed. He said the state is considering a move to the federal exchange, which has improved faster than Maryland's since its own disastrous launch, or a partnership with other states.

"Whatever works best to serve the greatest number of people most quickly is what we will do," the governor said.

Officials said they were working to track down people who started the application process since the website opened Oct. 1 but have been unable to complete it. They said the outreach includes emails, robocalls and mailings.

Isabel FitzGerald, the state's information technology secretary, said the state is also taking steps to beef up a call center that has had wait times of more than an hour. She said the state has brought in outside help for more routine cases so service representatives can concentrate on customers with more difficult problems.

Despite the problems, O'Malley said the state is more than halfway toward its goal of enrolling 260,000 in insurance programs under the health reform act by March 31. Counting additions to the Medicaid program as well as people who have signed up for private insurance through the exchange, he said, more than 152,000 people have been approved for new or improved coverage as of Dec. 28.

Of those, 18,257 have bought insurance on the individual market through the exchange. Most of those insured under the law, 134,635, will receive coverage through expansion of Medicaid, including 91,570 who were switched over from the state's bare-bones Primary Adult Care program to the more generous federal program.



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