File: Maryland Del. Heather R. Mizeur (D-Montgomery), a candidate for governor. (Marvin Joseph/WASHINGTON POST)

Amid all of the shortcomings and embarrassments of the Maryland health insurance exchange, Gov. Martin O’Malley (D) and other leaders have pointed to one bright spot: The number of people signing up for Medicaid has exceeded their expectations.

But Del. Heather R. Mizeur (D-Montgomery), who is running for governor, says Maryland is still not doing enough to get as many low-income families and individuals as possible signed up for Medicaid. Given that the federal government is picking up the cost of these new enrollees for the next few years, she said that not maximizing enrollment will only continue to cost the state in uncompensated care. State health officials argue their own strategies are working just fine.

Mizeur has proposed legislation — dubbed the Medicaid Streamlined Eligibility Act — that would require Maryland’s Department of Health and Mental Hygiene to adopt several strategies recommended by federal officials but, so far, not used in the state.

“The time to act on this is now,” Mizeur said while testifying before the Maryland House of Delegates’ Health and Government Operations Committee on Tuesday afternoon. “Many other states are doing this to really great benefit for their enrollees. And while we continue to work out the kinks in the exchange for the commercial market, there is so much more that we can do to enhance and streamline eligibility for our Medicaid beneficiaries.”

On the top of Mizeur’s list is the option to automatically enroll people who already qualify for food stamps and therefore have had their low income verified. She said the state should also seek to enroll the parents of children who have already been deemed eligible for health care and allow Medicaid recipients to hold their coverage for a full year instead of having their income re-verified every quarter.

“So that, like the rest of us, you have your coverage for a full year of enrollment rather than every quarter having to reshow that there has been no change in your income to dump you off of coverage,” Mizeur said.

A handful of health-care advocates also testified and backed Mizeur’s legislation, especially the piece that would allow for continuous coverage. One advocate pointed out that a burst of overtime pay can bump someone off Medicaid, even if his or her income has not really changed.

But providing that continuous coverage could cost the state at least $15.5 million more next year, according to legislative estimates. Mizeur called this spending a wise investment and said that cost could be absorbed by federal funds awarded to the state for having met certain enrollment goals. She pointed out that the state might already have to spend an extra $30.5 million on Medicaid because of shortcomings in the new exchange, which has had problems since it launched and might soon be replaced.

Joshua M. Sharfstein, Maryland’s secretary of health and mental hygiene, wrote in a March 10 “letter of concern” to the committee chairman that these strategies are not tailored to the state’s Medicaid program, and Maryland has already taken different steps that have “largely” done the same things.

Maryland has automatically enrolled nearly 96,000 people who were previously covered by a state health-care program. Many of those people also qualify for food stamps, Sharfstein wrote. As of Feb. 25, Maryland has newly enrolled 71,449 individuals in Medicaid, and tens of thousands more have been deemed eligible but have not yet enrolled.

“Over the last several years,” Sharfstein wrote, “Maryland has been a national leader in expanding access to affordable health coverage through the Medicaid program.”