Health advocates across the state have begun the final push to enroll citizens in insurance plans under health care reform, enticing them with a star Orioles player, extended hours and late-night breakfast at Denny's.
The Feb. 15 deadline to enroll is less than a week away, but those involved report that this year has been much smoother than last year, when technical problems plagued the state exchange, the website where people who do not get insurance through an employer or Medicare shop for plans.
"We are now able to deal with any little things that come up as we do with any IT system, resolve the issue and move on," said Carolyn Quattrocki, executive director of Maryland's exchange. "We are pleased with the way the system is working."
So far, the exchange reported 211,430 people have signed up for private health insurance or Medicaid in this enrollment period, which began Nov. 15.
Last enrollment season, the exchange crashed on its first day and staggered through an extended open enrollment to sign up about 300,000 people in private and public plans, including close to 100,000 who were automatically moved from a bare-bones state health plan into Medicaid, the federal-state program for low-income people.
After enrollment, the state used software from Connecticut to build a better system in Maryland.
There have been few kinks this year, Quattrocki said.
A surge of last-minute applicants could come in the final week, although enrollment has been pretty steady from week to week, she said. There will be no deadline extension like last year so people should pay attention to the deadline, she added.
Everyone who bought plans last year was re-enrolled automatically in the same or similar plans, but if they needed federal subsidies they are required to sign up again through the exchange. About 80 percent of people in private plans, or about 50,000 people, received subsidies.
One of those people was Anita Poquiz. Her son, Randy Poquiz, made sure to get his mother to the offices of Health Care Access Maryland, the Baltimore nonprofit that is helping people to enroll, way before the deadline.
Poquiz said his mom had no insurance before last year and often could not afford her medication she needed for a heart condition and high cholesterol. The 77-year-old would skip doses and wind up in the emergency room.
"She has been much healthier since getting insurance," said Poquiz, who works in health care.
At Healthy Howard, navigators are enrolling people on average within an hour. Last year, they never knew when the system would stall during an enrollment session, and it would take much longer.
The system is performing really well," said Christine Hall, executive director of Healthy Howard, which is helping to enroll people in the western part of the state. "You can tell by the numbers."
Groups throughout the state have tried original ways to encourage people to enroll.
Health Care Access For All, an advocacy group, enlisted Orioles player Adam Jones to record radio ads to encourage more people to sign up by the deadline.
"I know we can do even better with Adam Jones at bat," Baltimore Mayor Stephanie Rawlings-Blake said during a recent unveiling of the advertisement. "Let's get the word out and make sure more Maryland families are covered and more Maryland families are healthy."
Jones is expected to attract young people, a generally healthy demographic that is key to making reform work. The exchange also bought ads on YouTube and the music app Pandora. Other groups have opened "storefront" enrollment shops and Healthy Howard is hosting a late-night breakfast and enrollment event at a Denny's later this week.
"We certainly are making ourselves available and willing and able to help," Hall said.
Despite improvements in the exchange this year, there still are critics who argue taxpayer money was wasted on a system that didn't initially work. Audits by the inspector general for the U.S. Department of Health and Human Services and other government agencies looking into the issue are ongoing. State officials have said they would consider lawsuits to recoup money paid to contractors on the first troubled exchange, including Noridian Health Solutions, the prime contractor.
"When the government throws hundreds of millions of dollars into a project, the hardworking people of Maryland expect to see results," said Shelby Hodgkins, a spokeswoman for Rep. Andy Harris, a strong critic of reform. "Unfortunately, it took several years and millions in wasted taxpayer dollars to see any results with the Maryland exchange."
State House Minority Leader Nic Kipke of Anne Arundel County said he is pleased the exchange is now working.
"It is nice to see the government can finally get their act together and at least get a website working," Kipke said.
But he said there are other problems with health reform in the state. He believes a third-party administrator should run the exchange, and financial questions remain.
"We have expanded access to health care to a lot of people," Kipke said. "But the bottom line is nobody knows how it is being paid for. I also don't think there are enough controls in place."
Many Maryland residents said they are happy to get insurance despite the initial challenges with the exchange.
Mark Thomas, 52, worried about how he was going to stay healthy after he lost his job. He has a chronic illness that could kill him if he doesn't take his medicine. Under health care reform, he was able to get Medicaid.
"I need insurance to take care of myself," he said. "I don't know what I would do without it."