Maryland Health Exchange Failures Parallel Those of Federal Exchanges for All the Wrong Reasons

January 14, 2014

Despite Early and Eager Willingness to Embrace Health Law, Maryland Implementation Remains a Failure

WASHINGTON, DC – Just days before the launch of the health care exchanges, on September 26, President Obama traveled to a community college in Maryland to build excitement for the start of open enrollment. The president told folks, “Like any law, like any big product launch, there are going to be some glitches as this thing unfolds. Folks in different parts of the country will have different experiences. It’s going to be smoother in places like Maryland where governors are working to implement it rather than fight it.” Maryland was set to be the administration’s success story, until the system collapsed right out of the gate.

As The Washington Post reports, “Within moments of its launch at noon on Oct. 1, the website crashed in a calamitous debut that was supposed to be a crowning moment for Maryland officials who had embraced President Obama’s Affordable Care Act and pledged to build a state-run exchange that would be unparalleled.” The Maryland health care exchange does, in fact, have a parallel: the federal exchange, in more ways than one.

For years, supporters of the health care law pointed to Maryland as the example of a state fully embracing the health law, the state that all others should follow. Unfortunately, Maryland has proven to be a microcosm of the entire health care law rollout, but for all the wrong reasons.

The Washington Post reports, “More than a year before Maryland launched its health insurance exchange, senior state officials failed to heed warnings that no one was ultimately accountable for the $170 million project and that the state lacked a plausible plan for how it would be ready by Oct. 1.” Similarly, Energy and Commerce Committee members have uncovered documents revealing that top HHS and White House officials were briefed in April about the troubled timeline in getting to October 1 successfully. One of the concerns outlined in the report, prepared by McKinsey and Company at the request of the administration, was a lack of clear leadership, “Matrix management and consensus decision making//No clear roles, responsibilities and processes for making change//No single empowered decision-making authority//Lack of a ‘shared definition of success.’”

The failure of both Maryland and the federal government to successfully implement this law has led to very real health care nightmares for patients. CNN Money reports, “Many folks who signed up for coverage through the state and federal exchanges are running into roadblocks now that they are trying to use their new benefits.” The Washington Post editorial board adds, “the experience was so bad in Maryland that people couldn’t complete applications, and some of them are now or soon will be on the hook for high medical costs incurred since the beginning of the year, with no way to get coverage that takes effect before next month.”

Fox News reported last week, “Top Maryland Democrats are considering drastic measures to address ongoing problems with their state-run Obamacare website, including sending people directly to the already-strained federal exchange.” While the future of this change is still uncertain, Maryland is taking other steps to help people in the short term, but it comes with a hefty price tag. The Washington Post editorial board explains “There’s now a preliminary price tag on Maryland’s failure to roll out a functional health-insurance website: $5 million to $10 million. That’s an estimate of how much it will cost the state to offer emergency health coverage to people who couldn’t sign up on Maryland’s online Affordable Care Act (ACA) marketplace before Jan. 1.”

The federal health exchanges are also flawed, and have no alternative. Sadly, when supporters of the law said to look to states like Maryland for leadership in implementing this health law, they were correct, but for all the wrong reasons.