Maryland’s four major options for fixing its dysfunctional health exchange


File: A health navigator, center, assists enrollees using the Maryland Health Connection insurance exchange website at a health insurance education and enrollment event in Silver Spring, Maryland, U.S., on Saturday, Dec. 7, 2013. (Andrew Harrer/Bloomberg)

Maryland’s new online health insurance marketplace is so structurally flawed and dysfunctional that state officials say they will have to make major changes as soon as the first open enrollment period ends on March 31. They are still trying to figure out what those changes will be.

Isabel FitzGerald, Maryland’s secretary in charge of information technology, laid out four options during a legislative oversight meeting on Monday: Maryland could make major fixes to overhaul its existing system, adopt technology developed by another state, join a consortium of states or partner with the federal exchange to use some of its back-end services.

She said the goal is to have “a sustainable system for the long term.” As officials weigh these options, FitzGerald said they are considering how much customization would be needed to meet Maryland’s needs, what the cost would and if the switch can be made before the next enrollment period opens on Nov. 15, among other things.

FitzGerald and other health officials could not say when they expect to make their decision. State officials said Tuesday they are still more than a week away from making a decision, if not longer.

One of the options that Maryland is exploring is purchasing technology from Connecticut or partnering with the state in some way, according to state officials. Connecticut’s exchange has been one of the most successful in the country, and the state is setting up a consulting business so that it can advise other states or sell its technology, the New York Times reported. Connecticut has signed up about 55,000 people for private insurance plans through its exchange, beating its federally set goal of 33,000.

But that’s not the only option being explored, as officials say Maryland has also approached Kentucky about its exchange.

A Washington Post poll recently found that 60 percent of Democrats and 60 percent of Republicans in the state say they would rather see Maryland fix its exchange than adopt the federal system — a rare example of bipartisan agreement on the divisive issue.

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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