Marylanders have until December 15 to enroll in health plans under the Affordable Care Act.
Marylanders have until December 15 to enroll in health plans under the Affordable Care Act. (Getty Images / Getty Images)

Since the Affordable Care Act passed nine years ago, our state’s percentage of uninsured residents has been cut in half. Now, just about 6% of Marylanders remain without health insurance, according to U.S. Census data.

As we approach the end of this year’s open enrollment — the last day is Dec. 15 — we hope to reach these holdouts by breaking some misconceptions that keep people from enrolling. For instance, many may not realize that they qualify for financial assistance or that there are people available to navigate the process.


Who and where are the remaining 6% — more than a quarter-million people — and why haven’t they enrolled? After extensive research from focus groups, phone and online surveys and real-time webcam enrollments, we think we know the reason why. Health insurance is complex. It can feel exhausting to try to figure it all out. On top of that, many believe that health insurance is not affordable.

For the past two years, the Maryland insurance commissioner and Maryland Health Benefit Exchange, which manages enrollment for the state, have been working with the governor, the state legislature, the federal government and insurance companies to drive down costs, which have dropped a total of 23% the past two years. Health plans also have been reconfigured to cover more health services.

For 2020, new “value plans” are available on Maryland Health Connection, the marketplace where people can buy health plans. These plans offer coverage for services that the majority of people use most frequently, before the deductible is met. They are designed to lower out-of-pocket costs for primary care and urgent care visits, generic drugs, outpatient mental health and substance use disorder treatment and more.

Another obstacle we frequently hear of is a lack of understanding. Consumers just want someone to sit down with them and explain their options, what the jargon means and which plans are the best fit for them and their families. Free help is available. Hundreds of trained consumer assistance workers throughout the state, including insurance brokers and health navigators, are available to answer questions and help folks enroll. In addition, more than 200 experts work at our call center at 855-642-8572. Deaf and hard of hearing consumers may use Relay. Our language line also offers help in more than 200 languages.

This year’s marketing campaign says it all: “Start here!” For those who have access to a mobile device or desktop computer, MarylandHealthConnection.gov is a great place to start, even if you just visit the website to find in-person help near you.

Some uninsured Marylanders recall that the system didn’t work as smoothly as we hoped the last time they tried to enroll for health coverage years ago. What they may not know is that the failed system no longer exists. It was kicked to the curb and replaced with an efficient, user friendly website and a free mobile app so that consumers can upload documents securely, view their account and enroll in coverage.

Our research shows that certain populations are more likely to be uninsured, including young adults between 18 and 34, African Americans and Hispanic residents. Many of the remaining uninsured also reside in rural counties with plan offerings from only one insurance company, and where health services are not easily accessible. The silver lining is that these counties enjoy much lower monthly rates for 2020, as little as the cost of dinner and a movie.

People who have sought and obtained health insurance within the last six years report that they finally have peace of mind. Most uninsured people know that they are one illness or injury away from financial strife and even medical bankruptcy, and it scares them. Some were forced into coverage when the law mandated people sign up or face a penalty. Many of these people became converts and have maintained their coverage to keep themselves healthy.

If anyone knows someone who does not have health insurance, please reach out to them now and remind them about enrollment so that they can get covered. And if you don’t have insurance, I encourage you to give yourself and your family the peace of mind of knowing that you’re covered. Visit MarylandHealthConnection.gov before open enrollment ends Dec. 15.

Michele Eberle (michele.eberle@maryland.gov) is executive director of the Maryland Health Benefit Exchange.