Chet Burrell, president and chief executive officer of the Maryland-based CareFirst BlueCross BlueShield, has encouraged Maryland Gov. Martin O’Malley (D) to ignore calls for the state to abandon all or part of its health exchange and switch to the federal exchange, according to a letter Burrell sent Friday that was obtained by The Washington Post. Here’s the full text of that message:


As a follow on to our recent communication, I just want to say that, while I know your frustrations with Maryland’s efforts on the Exchange have been great, a move to the Federal Exchange at this time would present substantial new risks and costs. Indeed, it may go so further complicate an already complicated situation as to make any near term remedy virtually unattainable.

We are dealing directly with the Federal Exchange in Virginia and have extensive day to day experience with it. We find that there are many serious and persistent operating and technical issues that undermine effective enrollment. Missing functionality limits the ability to do basic things such as correct and maintain life event changes for people once they are enrolled. We are concerned about the confusion, poor service and anger this will produce.

All things considered, my strong advice would be that the State stay its course and fix as much as it can with its own Exchange during this current open enrollment period. While far from perfect, I believe this is the most stable and effective course and is mostly likely to lead to the enrollment of the greatest number of people possible which I know to be your interest. It also greatly facilitates our efforts to support you since we are very familiar with the work that is being done by the Maryland Exchange and with the processes and technology that underpin it (however flawed).

Once the current open enrollment period is complete and there is time to assess the lay of the land, we would be happy to advise, should you desire, on what future course of action might be in the best interest of the State of Maryland.


When reached for further comment, a CareFirst spokesman released this statement:

“We have worked and will continue to work with Maryland on Exchange-related matters. The perspective that we have provided the State has centered on working through the current open enrollment period ending in March with an emphasis on getting as many Marylanders enrolled as possible in the coming months.The bottom line being it would be ill-advised to change technology and processes in mid-stream. Instead, once this initial experience with open enrollment is in the books, all parties will be better positioned to focus on improving the process and evaluating alternative approaches going forward.”