Maryland’s difficulties getting its health exchange up and running drew criticism from politicos on both sides of the aisle on Monday.
Harford County Executive David Craig, a Republican candidate for governor, suggested giving up and relying on private insurers. Rep. John K. Delaney, a freshman Democrat, asked the state how easy it would be to switch to the federal exchange.
Delaney, who represents Western Maryland and Montgomery County, said he was disappointed with the state’s exchange, the Maryland Health Connection, which he said was further from reaching its enrollment goals than the federal site.
He sent a letter Monday to state health secretary Joshua M. Sharfstein requesting more details about the feasibility of switching temporarily to the feds while the state’s IT team works out the kinks.
But Craig said sending Marylanders to the federal website won’t yield better results. Healthcare.gov, Craig said, shares some of the nasty problems that have beset Maryland’s exchange, including unreliable communications with insurers that have left many consumers unsure whether they have successfully enrolled in a plan.
Craig said the state should stop funneling money into mending the exchange and spend it instead on educating the public about other ways to get coverage from an insurance company or broker.
“If the Maryland website has been a disaster, the federal website has probably been a partial disaster,” Craig said.
“This whole thing would have been much better if they’d shopped it out to the brokers six months ago,” he said. “The brokers know what they’re doing.”
The state has received about $123 million in federal grants to help roll out the exchange. Craig, who released the proposal with his running mate, Del. Jeannie Haddaway-Riccio, R-Eastern Shore, said he would like to seek a waiver from the U.S. Department of Health and Human Services that would allow the state to spend those funds on information campaigns instead.
Craig said he would keep the call centers that help people who need assistance with the exchange, but said he would like to re-examine the role of “navigators” who are working to help people understand their insurance options.
He acknowledged that it’s unlikely state officials will admit defeat and give up on the exchange, because of the political consequences.
On the other hand, switching to the federal exchange — an idea floated last month by Delaney and others — has started to appear increasingly possible.
Initially, state officials seemed to brush off the idea of switching, but at a news conference on Friday, Gov. Martin O’Malley said “we may very well reach a point” where the state decides it’s necessary to do so, even if only in a limited capacity. If the state does switch over to the federal site, it will likely be a temporary fix meant to give IT workers time to debug Maryland Health Connection.
Delaney said he agreed with the state’s original decision to create its own website and that he remains open to mending and continuing to use the site, if that’s the best option. He said he suggested the switch “so that peak volume of enrollees could be handled in advance of looming deadlines.”
He said he understands that transitioning to Healthcare.gov might pose “challenges that I am underestimating.”
“For this reason,” he wrote, “I am asking for a specific analysis from you as to the ‘pros and cons’ of switching to the federal exchange for all or part of the Maryland interface. This analysis … should cover a high-level overview of the technological feasibility, cost and timing considerations.”
In an interview after he submitted the letter, Delaney said his motivation for suggesting the switch was the impending deadline. “Hours matter,” he said — an expression he attributed to his time in the private sector:
Dori Henry, a spokeswoman for the Maryland Department of Health and Mental Hygiene, said Sharfstein does intend to respond to Delaney’s letter but couldn’t say when. She also could not provide a specific timetable for when the state would decide whether it makes sense to switch to the federal site.
“Once we have done a full analysis of how best to serve Marylanders, we will make a decision,” Henry said.
On Friday, Gov. Martin O’Malley and Lt. Gov. Anthony G. Brown announced they would push emergency legislation to provide state-sponsored coverage retroactive to Jan. 1 for people who tried to sign up for health insurance that would begin with the New Year but were unable to do so.
The coverage would be provided through the Maryland Health Insurance Plan, a state program that insures high-risk consumers, until the exchange is fixed. O’Malley and Brown said the number of people in that situation ranges from a few hundred to as many as 5,000.
In a statement, Haddaway said she opposes the administration’s proposal because “creating more bureaucratic complexity” is not the solution.
Delaney, however, called the proposal “a very good idea.”
Del. Heather R. Mizeur, a Democratic candidate for governor who represents Montgomery County, released a statement Monday in support of the emergency legislation.