Maryland has achieved its health insurance enrollment goal, thanks to a research error

For months, it looked like Maryland would barely meet, or even miss, the first enrollment goal for its new health insurance exchange. But it turns out the goal was based on flawed data, and the state’s new goal is one that it has already beat.

Instead of signing up 260,000 Marylanders for private plans or Medicaid during the first enrollment period, as was the original goal, the state is only expected to get 160,000, according to a letter the exchange’s interim executive director received from researchers Friday. So far, sign-ups tally nearly 190,000.

It’s a convenient correction for a state that’s home to one of the lowest performing exchanges in the country, one that is so technically flawed that state officials say they might soon abandon all or part of a system that cost tens of millions dollars to build.

“It’s better to have the correct data to put things into the proper context,” said Joshua M. Sharfstein, Maryland’s secretary of health and mental hygiene, in an interview Sunday. “This doesn’t change any of the challenges we’re facing, but it does put those challenges into context.”

Sharfstein said the state’s leading goal continues to be this: Sign up as many Marylanders as possible for health insurance coverage before open enrollment ends on March 31. The second enrollment period opens Nov. 15.

Maryland Gov. Martin O’Malley (D) has long said that he hopes at least 260,000 Marylanders will gain coverage through the exchange or Medicaid expansion during the first enrollment period. Of that group, officials expected that more than 150,000 would sign up for private plans through the exchange. Lt. Gov. Anthony G. Brown (D), who is in charge of implementing the Affordable Care Act in Maryland, offered an even higher prediction in a press release days before the exchange opened: 180,000.

Those goals were set using a July 2012 report by the Hilltop Institute at the University of Maryland Baltimore County, a nonpartisan health-research organization that is paid by the state to generate such reports.

The institute projected that from Oct. 1 to March 31, 147,233 Marylanders would become newly insured through the exchange. Additionally, during the first six months of Medicaid enrollment, 90,639 would automatically be enrolled and 11,046 would come out of the woodwork, not knowing they were Medicaid-eligible before contacting the exchange.

Those three groups add up to 248,918. The state’s goal became 260,000.

Many have called the rollout of the exchange on Oct. 1 an utter disaster. Despite hundreds of technical fixes since then, state officials say the exchange is still not operating as it should, and many applications are being tediously processed manually.

Enrollment in private plans has greatly lagged behind expectations, although Medicaid sign-ups have been higher than expected, largely making up for the difference.

As of Feb. 15, 33,251 Marylanders had enrolled in a private plan through the exchange. As of Feb. 18, 156,561 people were enrolled in Medicaid. That’s a total of 189,812. (There are also more than 90,000 people who have been deemed eligible for Medicaid and are likely to enroll.)

As problems with the exchange have gained increased attention, O’Malley and Brown have regularly and publicly discussed the enrollment goals, focusing chiefly on the overall goal. During a Sunday morning appearance on CBS’s “Face the Nation,” O’Malley said: “As a state, we were looking to sign up 260,000 people. Right now we’re at 200,000 that have signed up.”

A few weeks ago, exchange officials reached out to the Hilltop Institute and asked for undated enrollment predictions, said Cynthia H. Woodcock, executive director of the institute. That’s when researchers realized that they had made a mistake, labeling projections as being for fiscal years instead of calendar years, she said, which would cover two enrollment periods instead of just one. An erroneous footnote added to the confusion.

“We identified these errors and went, ‘ohhhh,’” Woodcock said in an interview on Sunday. “At Hilltop, we are researchers, and we stand by our numbers, but we made an error.”

Hilltop researchers will revise their work, but in the meantime they provided this “reasonable estimate” for the first enrollment period: 70,000 Marylanders in private plans and 90,000 in Medicaid for a total of 160,000.

And that’s a goal the state has already surpassed with a month to spare.

John Wagner contributed to this report.

Jenna Johnson writes about Maryland politics, including the General Assembly, the administration of Gov. Martin O'Malley and the 2014 election.
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