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Insurance option draws just 1,743

Just 1,743 uninsured Marylanders out of an estimated total of 800,000 signed up for private health insurance on the new state-run exchange in the first six weeks of the six-month open enrollment period, according to a report by the entity that operates the exchange.

In addition, 7,704 Marylanders had used the Maryland Health Connection website to learn that they are eligible for Medicaid, according to the report released Friday by the Maryland Health Benefit Exchange.

Officials have released an enrollment report every Friday since Maryland Health Connection went live on Oct. 1, but this was the first to separate Medicaid enrollment from enrollment in private plans, known as “qualified health plans” because they meet minimum federal standards. Past reports have counted both categories of enrollees as new in the same total.

Implementing more detailed reporting methods is one of several recent efforts by the state to be more responsive to the public and to clean up the exchange’s image, which has been tainted by technical malfunctions and reports of low enrollment. MHBE Executive Director Rebecca Pearce has taken responsibility for the website’s poor performance and promised to allocate more resources toward fixing the problems while keeping users informed of progress.

“Many Marylanders are now able to navigate the website through the entire process,” the report reads. “They can establish accounts, find out about eligibility for Medicaid and subsidies, shop for plans, and choose to enroll. We are working to address technical problems that are still causing error messages and delays for some Maryland consumers. In the last week, we completed an upgrade of key parts of the software and are implementing additional steps to improve connectivity.”

Friday’s report also provided some demographic information about enrollees in private plans, as well as which kinds of plans were most popular. These details will now be released once a month by the U.S. Department of Health of Human Services.

From Oct. 1 to Nov. 2, the Maryland exchange received 10,917 applications for coverage. Of those, 54 percent were determined to be Medicaid-eligible, and are now considered covered by that program. The rest of the applicants (5,923) were directed to choose a private plan, and 1,284 of them did so by Nov. 2.

From Nov. 2 to Nov. 9, the number of enrollees in private plans increased by 36 percent, to 1,743 enrollees.

Additionally, 83,991 individuals who are currently enrolled in the state’s Primary Adult Care (PAC) program will be automatically enrolled in Medicaid starting in January because PAC, which offers limited coverage to low-income adults, is being discontinued.

Officials said they expect more people to enroll in the more than 60 plans offered on the exchange “as the consumer experience on the website improves.” They expect up to 75 percent of enrollees to be eligible for some amount of tax credits to help cover the cost of premiums for qualified health plans.


The backdrop

When the MHBE report was released Friday, the spotlight was already shining hard on the new health insurance exchanges. A day earlier, President Barack Obama announced that consumers whose policies were recently canceled for not meeting new federal standards could, in fact, keep those policies for another year.

The president’s move signified a major concession to the millions of Americans — including about 73,000 Marylanders — who received, or were slated to receive, cancellation notices from insurers. However, rolling back enforcement of the requirement that plans meet the standards didn’t necessarily mean all those people would actually be able to keep their current, non-compliant plans.

That’s because Maryland was one of several states that amended state law a few years ago to align it with the federal Affordable Care Act — including the provision establishing minimum standards for what insurance plans must cover.

But with the federal requirement on hold, Maryland insurance company executives and state health care regulators spent the day scratching their heads, trying to discern whether it would even be possible under state law to re-introduce those non-compliant plans.

The Maryland Insurance Administration was caught up in determining whether Commissioner Therese Goldsmith has the authority to suspend enforcement of the standards in Maryland, according to a spokesman for the MIA.

Meanwhile, executives at CareFirst BlueCross BlueShield, the state’s largest insurer, were kicking around potential scenarios as they worked to determine what actions, if any, they could or should take to make the more than 43,000 plans they canceled available again.

“We urge everyone to understand that we are strictly bound by state laws,” CareFirst said in a statement released after Obama’s announcement. “At the moment, it is unclear whether state laws would preclude us from doing what the president has proposed. As soon as we know more and the direction is clear, we will be in communication with our subscribers.”

To some degree, the fate of Maryland Health Connection — and of the consumers who purchase plans there — depends on how the state decides to handle insurers’ non-compliant plans, several people said.

If individuals are allowed to keep noncompliant plans, that could have a detrimental impact on the exchange pool, according to the National Association of Insurance Commissioners. If insurance companies do restore the non-compliant plans, and if consumers decide to keep them, fewer people will head to Maryland Health Connection to purchase coverage, which would reduce the size of the risk pool.

NAIC said in a statement that the decision to delay enforcement of the minimum standards “threatens to undermine the new market, and may lead to higher premiums and market disruptions in 2014 and beyond.”