Marc Kilmer incorrectly stated in his January 28th letter that health insurance exchanges do not work ("Md. should not set up health insurance exchange". A robust exchange, modeled after the success one in Massachusetts, would provide a strong baseline that would provide health insurance to hundreds of thousands of uninsured Marylanders, all the while helping contain cost and provide affordable options to folks that have simply been priced out of the market.

The Massachusetts reforms have been judged a major success. Over 98 percent of residents there have coverage, compared to just 85 percent in Maryland. The proportion of those avoiding care due to cost is down substantially. Racial and ethnic disparities have been dramatically reduced. More small businesses are offering coverage to their workers, and increased preventive care is reducing the need for hospital stays.

And it has been affordable. A non-partisan analysis by the Massachusetts Taxpayers Foundation, a pro-business, anti-spending group, found that "the incremental cost to taxpayers has been modest and consistent with projections." The study concluded that "the overwhelming success of the effort in our state makes a compelling statement that national reform can succeed. One wonders why critics have been so zealous in distorting the facts to 'prove' that the Massachusetts reform is a failure. This is not some theoretical discussion but a real achievement and lifeline for hundreds of thousands of Massachusetts citizens."

The best indication is the continued overwhelming public support for the law. Voter support is over 67 percent. Even U.S. Sen. Scott Brown supports Massachusetts' health reform. Employers also support the law by a 2 to 1 margin.

We have made tremendous progress in Maryland during the past few years, with more than 250,000 people now covered by health care expansions. This is a great start, but we still have lots of work to do. By implementing a strong exchange, we can move toward our shared goal of quality, affordable health care for all Marylanders.

Matthew Celentano, Baltimore

The writer is deputy director of the Maryland Citizens' Health Initiative.