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Maryland's Obamacare Band-Aid [Editorial]

Laws and LegislationExecutive BranchAnthony BrownAffordable Care Act (Obamacare)Martin O'Malley

The General Assembly should approve Gov. Martin O'Malley's emergency proposal to allow temporary and retroactive enrollment in the state's existing high risk health insurance pool for those whose efforts to enroll in new plans were stymied by the technical disaster of Maryland's Obamacare exchange. The governor's proposal doesn't begin to make up for the damage done by the state's failure to deliver a workable exchange and may in fact provide a viable option for few of those who have suffered as a result. But it may be the only option available for helping Marylanders who tried to do the right thing and who would otherwise face ruinous bills until they can get private coverage.

The Maryland Health Insurance Plan has for a decade provided an option for those who can't otherwise get health insurance. It is supposed to disappear from existence now that the Affordable Care Act makes it illegal for insurance companies to deny coverage because of pre-existing conditions, and theoretically it still will. But MHIP had already notified some members in November that their plans would be continued for the first three months of 2014 because of the problems with the website. Now Governor O'Malley wants to extend the same option to all those who tried to enroll in health insurance before Jan. 1 and to make coverage retroactive to the first of the year to pay any bills that would have been covered if they had been able to enroll normally.

The O'Malley administration thinks that as many as 5,000 people might fall in that category, but how many of them would take the state up on the offer — and how high the bill would be for the taxpayers as a result — is completely unclear. MHIP policies, while a vital lifeline to many of those who have taken advantage of them, are generally not as attractive as those that are available on the exchange. MHIP plans often come with high deductibles and co-pays, and the premiums — which participating consumers would have to pay under the governor's plan — are generally more expensive than those available on the exchange. Moreover, we're talking about covering those who would otherwise be uninsured for a short period of time; those who enroll in a health insurance plan through the exchange by Jan. 15 can have private coverage starting Feb. 1.

The governor's proposed deal would only make sense for those who would face medical bills in the first month of the year that would exceed the entire annual deductible for an MHIP plan, plus the monthly premium. That may be a very small pool. Of course, it could also be a costly one to cover since, by definition, the only people who would likely bother to enroll are those with sky-high medical bills.

Lt. Gov. Anthony G. Brown estimated on Friday that the proposal could cost the taxpayers $5 million to $10 million, thought that's really a guess. Republican lawmakers have already objected to the notion that the taxpayers should be on the hook at all for what they see as the failure of Messrs. O'Malley and Brown to deliver a workable website on time. Indeed, it would be unfair for taxpayers to pick up the tab for mismanagement, but it would be more unfair for those who tried to buy health insurance on time to face catastrophic bills. If voters conclude that the politicians in charge of the state's insurance exchange are to blame, they have an opportunity to exact accountability through the ballot box, at least in the case of Mr. Brown, who is running for governor. Ultimately, though, the state can and should seek compensation from the vendor, which was paid tens of millions of dollars but delivered one of the most troubled exchange websites in the nation.

The General Assembly should make enacting this legislation its top priority. But it should also move quickly to begin investigating what went wrong with the exchange website. The public needs to know what happened both to hold those responsible accountable and to ensure that problems like these do not recur.


To respond to this editorial, send an email to talkback@baltimoresun.com. Please include your name and contact information.

Copyright © 2014, The Baltimore Sun
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Laws and LegislationExecutive BranchAnthony BrownAffordable Care Act (Obamacare)Martin O'Malley
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