Only nine Marylanders have signed up for the state’s retroactive health insurance

Only nine Marylanders have signed up for temporary, retroactive health insurance made possible by emergency legislation aimed at helping people who tried to get coverage through the state’s faulty online health insurance marketplace, encountered problems and were stuck with medical bills to pay.

Two months ago, state officials predicted that as many as 5,000 people might need the help, which would have cost the state millions of dollars. Since then, the four health insurance companies participating in the state exchange offered their own retroactive insurance, helping about 300 households — and turning the state’s option into a last-resort for special cases.

The small number of enrollees “is a sign that there are not so many people who are having so many challenges that they are going that route,” said Joshua Sharfstein, Maryland’s secretary of health and mental hygiene, at a budget hearing Wednesday. “We’ve been doing an enormous amount of work — a lot of elbow grease — to try to patch different parts of the system so that we can get through open enrollment.”

But at budget hearings and an oversight meeting this week, a few lawmakers questioned whether the low number of is really a sign of success. Some asked what the state is doing to promote the option. Senate Minority Leader David R. Brinkley (R-Frederick) said Monday that he has diminishing confidence in the exchange’s ability to make any accurate predictions.

On Friday, federal health officials announced they will bend some of their rules in the coming month to help those living in states where the exchanges that have not been working well, which could include Maryland. The government plans to help pay for certain health plans that consumers buy on their own — not through the exchange — and help make that insurance retroactive.

Maryland was one of 14 states that decided to build its own online health insurance marketplace, a key feature of President Obama’s Affordable Care Act, rather than rely on the federal version. But Maryland’s site crashed on its first day and has yet to work as planned, greatly hindering enrollment in private health insurance plans.

As of Feb. 22, 35,636 Marylanders had enrolled in a private health plan through the exchange, far behind the original goal of having at least 150,000 people signed up by the end of March. Earlier this week, state officials announced that their goal was based on faulty research and that a better estimation is 75,000 to 100,000 people. Enrollment for those plans opened Oct. 1 and will close March 31. The next enrollment period, for insurance starting in 2015, will open Nov. 15.

The exchange has been working better than when it first launched,with technology officials saying that they have fixed hundreds of glitches and continue to work on hundreds more. But when the New Year rolled around, thousands of Marylanders who needed health insurance were still without it.

In early January, Maryland Gov. Martin O’Malley (D) and Lt. Gov. Anthony G. Brown (D) asked lawmakers to help those people. The administration proposed legislation to expand enrollment in a state-run insurance program — called the Maryland Health Insurance Plan — that was established a decade ago to help high-risk individuals who couldn’t get coverage elsewhere. People in dire need of health insurance could enroll in this program and receive coverage that is retroactive to Jan. 1 or the first day of following months. The premiums of these plans are often higher than in private plans, which was expected to motivate people to not stay for long.

As lawmakers weighed that option, the four insurance companies participating in the exchange provided their own retroactive health insurance. For one week in mid-January, Marylanders could register to receive insurance that would be retroactive to Jan. 1. More than 1,300 households expressed interest. Of those, 562 were found to be eligible for Medicaid and nearly 300 households enrolled. All of those applications had to be manually processed and did not go through the exchange.

Once that happened, state officials said there was less of a need for the state to also offer retroactive insurance, but they said there could still be a few hundred people who require the help.

When O’Malley signed the legislation into law in late January, he said: “If it affects just one family, it is worth the effort, especially depending on the condition or the size of a hospital bill or other treatment bill incurred.”

Carolyn A. Quattrocki, the exchange’s acting executive director, told lawmakers Monday that about 7,000 applications are still stuck in Maryland’s system. As for the exact number of people who are not getting the health insurance they seek, a spokeswoman for the exchange said Friday that they do not have “any reliable estimate.”

Jenna Johnson is a political reporter who is covering the 2016 presidential campaign.

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