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Vincent DeMarco, president of the Maryland Citizens’ Health Initiative, is a supporter of raising the state’s tobacco tax. The proposal faces stiff opposition from a variety of businesses. (The Daily Record/Maximilian Franz)

Republicans eye changes to health exchange under Hogan

GOP leaders hope Hogan era will mean more transparency

Maryland Republicans say they are hopeful that Gov.-elect Larry Hogan will usher in a new era of transparency and, perhaps, other changes related to the much-maligned Maryland Health Benefit Exchange.

A revamped version of the site, which crashed on the day it launched last year, is being re-launched later this month for the fall open enrollment period. But top Republicans — including Rep. Andy Harris and Del. Kathy Szeliga, R-Baltimore and Harford — said Hogan’s election should lead to less secrecy about the exchange’s operations and what led to the fiasco in 2013.

Szeliga, the minority whip, said she is hopeful that a Hogan administration will be more forthcoming with information about the exchange, including the release of public documents to consumers, members of the media and legislators.

“I don’t think we’ll have to file public information requests,” Szeliga said.

Information regarding exchange operations has been tough to come by. The board overseeing the exchange frequently holds closed meetings in which contracts are discussed and approved, and it has flouted the Maryland Public Information Act by delaying the release of information for months after the required 30-day limit without asking for extensions.

A report from the Office of Legislative Audits reviewed documents released by the exchange to the public under the act and found redactions in the 14,500 pages of records “did not provide any clear indication of the oversight and governance structure that may have existed to oversee and steer the [health exchange website] development process.”

The site is also the subject of a federal investigation by the inspector general of the U.S. Department of Health and Human Services.

“We’ll get to the bottom of it,” Harris said of the problems with the site.

Harris, who favors moving to the federal exchange, said the new governor may want to do just that if the new site also falters.

“I don’t know how well this is going to work,” said Harris of the upcoming open enrollment period. “Going forward, I hope we’ll be able to administer the exchange if we decide to stay with it.”

Maryland officials and supporters of the state-run exchange, known as Maryland Health Connection, believe the refurbished system is in much better shape than the original website.

Over the past several months, exchange officials have been working to revamp the site using new contractors and new technology from another vendor, Deloitte Consulting LLP, which was implemented successfully in Connecticut during the first enrollment period.

“There are all expectations that the website and the enrollment are going to work,” said Vincent DeMarco, president of the Maryland Health Care for All Coalition. “We think the open enrollment effort will work well.”

DeMarco said he believes the state should maintain its separate exchange, rather than switch to the federally operated site.

“There are a lot of ways that this system is very unique to Maryland,” DeMarco said. “We should continue to do our own thing.”

DeMarco’s sentiment is similar to views expressed a year ago when Maryland rolled out the first iteration of the exchange website. But despite officials’ stated confidence in the system, the site crashed on Oct. 1, the day it was launched, and continued to be plagued with issues.

Eventually, state officials fired the prime contractor, replaced the exchange’s executive director, scrapped the system’s underlying technology and adopted the software developed by Deloitte for Connecticut’s exchange.

The issue also became a political football of sorts with both Hogan and Democrat Douglas F. Gansler, a primary contender for the Democratic gubernatorial nomination, criticizing Lt. Gov. Anthony Brown for his role in overseeing the state’s exchange.

A year later, state officials continue to be hopeful that this year’s version will be much improved.

In September, information technology Secretary Isabel FitzGerald told a joint legislative oversight committee she was optimistic about the November open enrollment period.

“We are about 60 days out,” FitzGerald said. “It’s very exciting and very scary in a way.”

Since then, the state has been testing and retesting the website, slowly ramping up the number of simulated users who could use the site at the same time from about 2,000 people to 5,000 or more.

“There will be some things we may have to tune in that first week, which is one of the reasons that first week will be so critical for us,” FitzGerald told legislators. “While you can simulate users, what you can’t predict is unpredictable actual human behavior.”

DeMarco said it is too soon for Harris, Hogan or anyone else to think about closing down the exchange, which signed up more than 400,000 people, most of whom are enrolled in Medicaid.

“We should reserve judgment on the site and moving to the federal exchange until we see how it all works,” DeMarco said.