Maryland exchange, model of Obamacare implementation, won’t be fixed until December

posted at 10:01 pm on October 17, 2013 by Mary Katharine Ham

Since the day the Affordable Care Act passed Congress, the state of Maryland has been among the most eager to implement it, and among the most likely to launch an exchange smoothly. It’s a thoroughly blue state populated by politicians who pride themselves on the state’s hefty and experienced health care bureaucracy.

Maryland’s Gov. Martin O’Malley, a presidential aspirant happy to charge forth with the Obamacare banner, held a press conference the day after its passage proclaiming the Old Line State’s intention to tow the line. In 2009, as the Obamacare debate raged, he declared Maryland uniquely suited to the task: a state of a “manageable size” and with more “PHDs per capita than any other state in the union.”

“[H]igh technology, IT, is one of our core strengths, one of our ‘economic and talent strengths’ as a state,” O’Malley said.

O’Malley’s certainty was one of the reasons President Obama chose Maryland for a speech in September touting Obamacare exchanges on the eve of their debut:

“Now, this is real simple,” Obama told a crowd at Prince George’s Community College. “It’s a website where you can compare and purchase affordable health insurance plans, side-by-side, the same way you shop for a plane ticket on Kayak, same way you shop for a TV on Amazon. You just go on and you start looking, and here are all the options.”

But a week into its launch, the Maryland exchange had reportedly enrolled only 326 people.

A week later, the number had improved to just a little over 1,000, and O’Malley told reporters it could be six weeks before the exchange website was working smoothly.

“My sense of it is, probably for the next month or so, month and a half, we will be working out glitches in the portal,” he said.

That timeline should frighten the administration, whose disastrous federal exchange site is arguably more broken than Maryland’s, with much more asked of it.

It’s likely already scaring Dr. Peter Beilenson, whose Evergreen Health Co-Op is a new non-profit health company entirely dependent on the exchanges for enrollees. His concerns about the glitch-ridden system last week take on more significance in the wake of O’Malley’s announcement.

“If this were November 15th, I’d be really, really worried,” Beilenson told a Baltimore radio station. “[But] this being October 9th, I’m not terribly worried at this point, because I’m sure they’ll get this thing up and running better.”

Beilenson’s comment touches on the real timeline for improving exchanges. The deadline for citizens to purchase health insurance to prevent a penalty is mid-February, but applications for those who have managed to sign up are supposed to be processed by Jan.1. The deadline may be much sooner, as Megan McArdle explained, to prevent the “death spiral” that happens when too few young, health people sign up, the preponderance of older sicker people makes premiums spike, and more young, healthy people drop insurance because it’s no longer affordable. “Rinse and repeat and you have effectively destroyed the market for individual insurance policies.”

In the private sector, this system would already have been rolled back, probably less than 48 hours after it was rolled out. The government has more time, but not that much more, because every day they wait adds to the chaos that will occur if they have to pull the plug in December. If the system cannot reliably process 50 percent of its users on Nov. 1 — and I mean from end to end, including sending a valid enrollment file to the insurer — then the administration should ask for a one-year delay of Obamacare’s various regulations, including the individual mandate. Congress, including Republicans, should be ready to give it to them, with no strings attached.

Perhaps Nov. 1 seems too aggressive to you. I chose that date because it’s when Jon Kingsdale, who ran the Massachusetts exchange for its first five years, said we would be “really in deep doo-doo.” Well, let’s say Nov. 15 — the date when almost all the experts I’ve heard say we really need to be running at full speed, to handle the crush of applications sure to come between Thanksgiving and the mid-December deadline for buying insurance that starts in January.

O’Malley’s estimate puts Maryland’s exchange running well, in a best-case scenario, in mid-November. Using the outside limit of his guess, it’s the beginning of December. Realistically, using a politics-to-English translator, it’s much later than that.

This is the state that prides itself on passing a health reform bill in 1993 when the nation did not. This is the state that’s a perennial leader in the number of health care mandates it places on businesses and consumers, and has the army of health regulatory bodies to match.

Even when the administration delayed important rules to prevent them becoming election fodder, Maryland forged ahead without. Formed by state legislation in early 2011, the Maryland Health Benefit Exchange Board met at least once a month starting in June 2011 to plan the build. The board, ironically, has a thorough and functioning website of its own. A calendar of events lists more than 200 meetings of exchange officials, working, business, and community groups about the exchanges over the last two years.

There was an undercurrent of apprehension at board meetings, but optimistic assessments and sunny PowerPoints papered over the real problems. At a December 2012 town hall meeting, exchange Chief Information Officer Kevin Yang joked that you could identify the IT guys in the room because they were the ones “sweating profusely.”

“We’re still waiting for certain standards to become official which is presenting some challenges …as far as timing,” Yang said, when asked in 2012 about delayed rule-making from the feds affecting their “aggressive” timetable.

At a spring meeting, board members engaged in a bit of tragicomic foreshadowing, as they discussed disappointing focus-grouping. It showed citizens’ principal doubts about exchanges: They “have had bad experiences with government programs” and had “built up their defenses surrounding health insurance and anything government related,” researcher Colleen Learch of KRC Research informed them. The solution, board members agreed, was a messaging one, not a technical one.

“We have to make sure the messaging breaks down those defenses,” Learch said.

Jonathan Cohn, a health care reporter at The New Republic and an Obamacare supporter, declared in 2011, “none are moving as quickly, or effectively, to follow through on the law as Maryland Governor Martin O’Malley.”

Sarah Kliff, now a health reporter at the Washington Post, noted Maryland’s healthcare exchange progress was so rapid, it had “caught the attention of the Obama administration.”

If there was ever a state that was, in good faith, trying hard to get an exchange operational, Maryland was it.

And, yet, Maryland produced a disaster that may not be fixed in time to prevent the “death spiral.” The minutes of the last exchange board meeting before the launch betray no serious worry about what was about to happen, though there was a closed board meeting in September that may have been more colorful:

Chairman Sharfstein welcomed everyone and commended the continued work of the Maryland Health Benefit Exchange (MHBE)
staff as open enrollment begins on October 1st. Ms. Pearce commented on the MHBE’s continued preparation and testing of the various systems.

At its Oct. 8 meeting, the board was tallying paper applications (866) and “implementing work-arounds.”

Back in 2009, when O’Malley was touting Maryland as the ideal state to lead ambitious national health reform, he had some words for anyone who doubted the federal government could pull it off:

Just because it’s not easy doesn’t mean that it doesn’t need to get done. And just because it’s difficult doesn’t mean that it won’t get done. It’s amazing what happens if we stick to the goal, if we keep pounding on those beliefs that unite us.

We’re coming off of eight years of a President who was very adept at belittling government and undermining any public confidence in our ability as a people to still get big things done through our government. But we’re turning the corner on that.

Yet when the Bush administration built a federal exchange for Medicare Part D—a bumpy implementation of its own in some ways— it anticipated “20,000 simultaneous users and built capacity for 150,000,” prompting the USA Today editorial board to proclaim, “That’s the difference between competence and incompetence.”

A little more healthy skepticism from Obamacare supporters like O’Malley about what the federal government could “get done” might have helped them actually get it done.

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Your emergency triple bypass operation won’t be done until December.

/Obamacare death panel support staff

SparkPlug on October 17, 2013 at 10:06 PM

Since the day the Affordable Care Act passed Congress, the state of Maryland has been among the most eager to implement it, and among the most likely to launch an exchange smoothly. It’s a thoroughly blue state populated by politicians who pride themselves on the state’s hefty and experienced health care bureaucracy.

“We’re already Socialists!”

Axe on October 17, 2013 at 10:06 PM

Unfortunately, due to a lack of disc space we can’t process your 911 call so you will have to fill out form 545-34.c so we can send over a turnip truck to pick you up with the other dead bodies.

SparkPlug on October 17, 2013 at 10:08 PM

Oh that picture……… Says it all. :)

ThePrez on October 17, 2013 at 10:08 PM

The Adorable care act is pretty ugly.

The Affordable care act is pretty expensive.

SparkPlug on October 17, 2013 at 10:09 PM

Oh that picture……… Says it all. :)

ThePrez on October 17, 2013 at 10:08 PM

derp

Axe on October 17, 2013 at 10:09 PM

The campaign ads are going to write themselves.

But of course, the Republicans will then go in and edit the commercials and put the kid gloves back on.

Because they are the Stupid Party, after all….

nukemhill on October 17, 2013 at 10:12 PM

Unfortunately, we have limited supplies of the medicine you need to live but we got oodles of red tape to wrap your Christmas presents with if you live long enough.

/Obamacare death panel support staff, we are here to pull your feed tube

SparkPlug on October 17, 2013 at 10:12 PM

Oh that picture……… Says it all. :)

ThePrez on October 17, 2013 at 10:08 PM

Yep, the nation’s first special needs governor.

TXUS on October 17, 2013 at 10:13 PM

In 2009, as the Obamacare debate raged, he declared Maryland uniquely suited to the task: a state of a “manageable size” and with more “PhDs per capita than any other state in the union.”

That should double the cost right there.

slickwillie2001 on October 17, 2013 at 10:13 PM

Heh – I can’t wait until the loony liberals in Maryland descend on clinics and hospitals in January demanding their “ObamaCare”…..really, tens of millions or perhaps hundreds of millions of Americans will be shocked to learn that “ObamaCare” is not FREE healthcare…..

They will be marching on D.C. demanding Obama’s head on a pike……

I guess Obama will sike the Park Service on them….

Or probably more likely – Obama will nationalize all healthcare workers as Federal employees and demand they treat anyone and everyone who walks through the doors. Let’s see how long that will last.

redguy on October 17, 2013 at 10:13 PM

In 2009, as the Obamacare debate raged, he declared Maryland uniquely suited to the task: a state of a “manageable size” and with more “PhDs per capita than any other state in the union.

And why Maryland will not be allowed to join the United States of Texas, when that time comes.

TXUS on October 17, 2013 at 10:16 PM

then the administration should ask for a one-year delay of Obamacare’s various regulations, including the individual mandate. Congress, including Republicans, should be ready to give it to them, with no strings attached.

F*CK NO!

YOU wanted this so I am for implementing Obamacare EXACTLY as written, passed by Congress, signed into law by Obama, upheld by the Supreme Court, and regulated by Cruella Sebelius.

Americans need to learn that elections DO have consequences and they must bear responsibility for them.

Let the pain rain…hard.

Resist We Much on October 17, 2013 at 10:17 PM

Might be the best post photo ever.

forest on October 17, 2013 at 10:17 PM

Here is the bill for your free affordable health care plan.

You may check the check box below to donate one of your kidneys if you can’t afford to pay for the free health plan. We will send over one of our purple shirted union goons to remove your kidney and weigh it so the we may asses its value and deduct it from your bill.

/Obamacare death panel support staff, your organs can be our organs, its simple, fast and worry free.

SparkPlug on October 17, 2013 at 10:19 PM

“Now, this is real simple,” Obama told a crowd at Prince George’s Community College.

Obama could be completely clueless of what he’s talking about when he says building something like Amazon is “real simple”. Or, he could be lying.

Or maybe both.

Socratease on October 17, 2013 at 10:21 PM

Please fill our your medical coverage form below. Be sure to let us know your political party affiliation as it will impact if and when we can schedule your emergency triple bypass operation.

/Obamacare death panel support staff, how you vote can determine whether you live or die.

SparkPlug on October 17, 2013 at 10:23 PM

F*CK NO!

YOU wanted this so I am for implementing Obamacare EXACTLY as written, passed by Congress, signed into law by Obama, upheld by the Supreme Court, and regulated by Cruella Sebelius.

Americans need to learn that elections DO have consequences and they must bear responsibility for them.

Let the pain rain…hard.

Resist We Much on October 17, 2013 at 10:17 PM

^ Reiterating my commitment to this.

Axe on October 17, 2013 at 10:25 PM

Oh that picture……… Says it all. :)

ThePrez on October 17, 2013 at 10:08 PM

Yep, the nation’s first special needs governor.

TXUS on October 17, 2013 at 10:13 PM

….I’m sorry…but that ….made me laugh!

KOOLAID2 on October 17, 2013 at 10:26 PM

Let the pain rain…hard.

Resist We Much on October 17, 2013 at 10:17 PM

I agree with you on that but pushing BarkyCare forward in any way, shape, or form is not the right move. It must be attacked, hampered, slowed, … anything. Pushing its full implementation won’t do anything to get it repealed but only to have it set in stone – no matter how bad, stupid, insane, or painful it is to people. The damage that it wreaks will be essentially irreparable and BarkyCare, itself, will be here to stay.

The only way BarkyCare should be pushed to any implementation in any way is after a national divorce. Then, I’d donate money to get BarkyCare forced ont he American Socialist Superstate to hasten its demise. But, in the end, there will be only a pathetic smoking pile remaining, as the leftists deserve.

ThePrimordialOrderedPair on October 17, 2013 at 10:27 PM

more “PhDs per capita than any other state in the union.

You mean like the ones on “Ancient Aliens”?

Gotcha, derp boy.

98ZJUSMC on October 17, 2013 at 10:29 PM

I agree with you on that but pushing BarkyCare forward in any way, shape, or form is not the right move. It must be attacked, hampered, slowed, … anything. Pushing its full implementation won’t do anything to get it repealed but only to have it set in stone – no matter how bad, stupid, insane, or painful it is to people. The damage that it wreaks will be essentially irreparable and BarkyCare, itself, will be here to stay.

The only way BarkyCare should be pushed to any implementation in any way is after a national divorce. Then, I’d donate money to get BarkyCare forced ont he American Socialist Superstate to hasten its demise. But, in the end, there will be only a pathetic smoking pile remaining, as the leftists deserve.

ThePrimordialOrderedPair on October 17, 2013 at 10:27 PM

^ Reiterating my belief that delaying implementation of Obamacare isn’t hampering it, but assisting it.

Axe on October 17, 2013 at 10:29 PM

Obama could be completely clueless of what he’s talking about when he says building something like Amazon is “real simple”. Or, he could be lying.

Or maybe both.

Socratease on October 17, 2013 at 10:21 PM

Not clueless at all, just an abject prevaricator of mendacities, small and large.

And, as to Amazon, last I checked you don’t have to set up an account before you shop around — they’re not worried about sticker shock and I doubt will link your info directly to the DNC.

TXUS on October 17, 2013 at 10:30 PM

I’m glad the msm is reporting this, but as far as I’ve seen, the lefty websites like HuffPo are still completely in denial. I don’t think they can keep ignoring this problem forever though.

juliesa on October 17, 2013 at 10:30 PM

^ Reiterating my belief that delaying implementation of Obamacare isn’t hampering it, but assisting it.

Axe on October 17, 2013 at 10:29 PM

“If you were right, I’d agree with you.” :)

ThePrimordialOrderedPair on October 17, 2013 at 10:31 PM

And, as to Amazon, last I checked you don’t have to set up an account before you shop around — they’re not worried about sticker shock and I doubt will link your info directly to the DNC.

TXUS on October 17, 2013 at 10:30 PM

And people don’t go on Amazon to compare prices on Amazon, itself. They go on other sites and in stores and then go on Amazon to see if the price on Amazon (the lowest price, which is the one that Amazon attaches to each item listing) is better.

ThePrimordialOrderedPair on October 17, 2013 at 10:34 PM

The man in the picture looks like one goofy doofus.

bluegill on October 17, 2013 at 10:35 PM

http://www.baltimoresun.com/bal-te.md.omalley18oct18,0,5767021.story


‘”But the mayor’s anger also erupted when a caller to the show suggested that O’Malley was absent while drug dealers had seized control of the city. The show’s co-host, Douglas, relentlessly [LOL!] needled the mayor, criticizing police Commissioner Edward T. Norris and implying that O’Malley was a “nitwit” who had been hiding from the public.

“If Baltimore residents are going to keep electing the same nitwits year in and year out, they get what they deserve,” Douglas said.

O’Malley fired back: “I think you do the body politic a grave disservice when you blame these heinous acts on the so-called nitwit politicians.”

Douglas tried to compliment the mayor, saying that O’Malley’s shaking hands and teary eyes “shows the passion you have for the city.”

O’Malley didn’t take it well. “On that note, that probably is a good way to exit,” he said. “And gentlemen, if you enjoyed that, come outside after the show, and I’ll kick your ass.”‘

shorebird on October 17, 2013 at 10:36 PM

Kennedy: We will land a man on the moon before the end of the decade.

Obama: We will sign a man up for Obamacare before the end of the decade.

kcewa on October 17, 2013 at 10:38 PM

Oh that picture……… Says it all. :)

ThePrez on October 17, 2013 at 10:08 PM

derp

Axe on October 17, 2013 at 10:09 PM

+1 on the derp photo

if only these derps weren’t so dangerous

LaughterJones on October 17, 2013 at 10:38 PM

Who wants to bet it will work on 01/01/14 or 07/01/14?

burt on October 17, 2013 at 10:39 PM

Mary K, Obots aren’t required to ‘think’. They are merely required to be echo chambers for The Chosen One.

GarandFan on October 17, 2013 at 10:39 PM

Maryland exchange, model of Obamacare implementation, won’t be fixed until December of what year I dare ask?

meci on October 17, 2013 at 10:39 PM

^ Reiterating my belief that delaying implementation of Obamacare isn’t hampering it, but assisting it.

Axe on October 17, 2013 at 10:29 PM

I agree, delay in almost all cases is better left for the bedroom. Here, let the inevitable Orgasm from Hell be as premature as possible, and the let down from the fvckees be just as harsh and inconsolable as it gets.

TXUS on October 17, 2013 at 10:41 PM

I agree, delay in almost all cases is better left for the bedroom. Here, let the inevitable Orgasm from Hell be as premature as possible, and the let down from the fvckees be just as harsh and inconsolable as it gets.

TXUS on October 17, 2013 at 10:41 PM

lol :)

Axe on October 17, 2013 at 10:43 PM

I honestly can’t understand why obama didn’t offer to “concede” on the delay. It was a gift.

Ronnie on October 17, 2013 at 11:34 PM

WINNING!!!

John the Libertarian on October 17, 2013 at 11:34 PM

If the system cannot reliably process 50 percent of its users on Nov. 1 — and I mean from end to end, including sending a valid enrollment file to the insurer — then the administration should ask for a one-year delay of Obamacare’s various regulations, including the individual mandate. Congress, including Republicans, should be ready to give it to them, with no strings attached.

No.Way.In.Hell.

Barry refused to even consider a delay when House republicans asked for it, rejecting it out of hand.
President I Won should get exactly what he demanded. Implementation of “the law of the land” on schedule, no delays, no excuses.

Let the FAIL rain down on liberalism.

Curmudgeon on October 17, 2013 at 11:45 PM

Hispanics will continue to support it anyway because they like socialism, and Republicans will continue to encourage mass immigration because not to would be “racist”. The race problem is more important to Republicans than the socialism problem.

“Anti-racist” is a codeword for antiwhite.

David Blue on October 18, 2013 at 2:12 AM

I honestly can’t understand why obama didn’t offer to “concede” on the delay. It was a gift.

Ronnie on October 17, 2013 at 11:34 PM

He won. He wants to ride his chariot over the necks of his enemies and glory in their fall. That is what the left understands by “winning”.

David Blue on October 18, 2013 at 2:14 AM

O’Malley’s estimate puts Maryland’s exchange running well, in a best-case scenario, in mid-November. Using the outside limit of his guess, it’s the beginning of December. Realistically, using a politics-to-English translator, it’s much later than that.

Want to hear a joke?

Martin O’Malley.

I’ll be here all week!!

This man has broken an already ruined state. And now he wants to be President. Good times… Gooood times…

Gatsu on October 18, 2013 at 7:25 AM

O’Malley didn’t take it well. “On that note, that probably is a good way to exit,” he said. “And gentlemen, if you enjoyed that, come outside after the show, and I’ll have my armed detail of bodyguards kick your ass.”‘

shorebird on October 17, 2013 at 10:36 PM

Missed part of the quote :-P

Gatsu on October 18, 2013 at 7:27 AM

I love the picture of that goofy goofball, unfortunately my governor El Schmucko O’Malley. Another embarassment for the Irish American community.

NavyMustang on October 18, 2013 at 7:38 AM

If the system cannot reliably process 50 percent of its users on Nov. 1 — and I mean from end to end, including sending a valid enrollment file to the insurer — then the administration should ask for a one-year delay of Obamacare’s various regulations, including the individual mandate. Congress, including Republicans, should be ready to give it to them, with no strings attached.

I like that. If I read this correctly, it would be acceptable to have a 50% FAILURE RATE in order to continue using this broke duck website. Wow! Just WOW!

NavyMustang on October 18, 2013 at 7:41 AM

Maryland exchange, model of Obamacare implementation, won’t be fixed until December of what year I dare ask?

meci on October 17, 2013 at 10:39 PM

Oh, you cynic you! You have learned well.

NavyMustang on October 18, 2013 at 7:43 AM

You know what’s truly scarily about this. Maryland is the best case for Obamacare. Nice post MK.

flackcatcher on October 18, 2013 at 7:46 AM

Oh that picture……… Says it all. :)

ThePrez on October 17, 2013 at 10:08 PM

Looks like the winner of Monty Python’s Upper-Class Twit of the Year Award.

Athanasius on October 18, 2013 at 8:53 AM

Well, let’s imagine what will happen come January when people are going to start filing claims under this new system. That process probably will not go any smoother.

sydneyjane on October 18, 2013 at 9:09 AM

Model.

CWchangedhisNicagain on October 18, 2013 at 9:22 AM

If the system cannot reliably process 50 percent of its users on Nov. 1 — and I mean from end to end, including sending a valid enrollment file to the insurer — then the administration should ask for a one-year delay of Obamacare’s various regulations, including the individual mandate. Congress, including Republicans, should be ready to give it to them, with no strings attached.

No.Way.In.Hell.

Barry refused to even consider a delay when House republicans asked for it, rejecting it out of hand.
President I Won should get exactly what he demanded. Implementation of “the law of the land” on schedule, no delays, no excuses.

Let the FAIL rain down on liberalism.

Curmudgeon on October 17, 2013 at 11:45 PM

The problem with that idea is that The One will merely implement the change by imperial fiat as he has for most of the other changes so far.

Kevin K. on October 18, 2013 at 9:34 AM

I honestly can’t understand why obama didn’t offer to “concede” on the delay. It was a gift.

Ronnie on October 17, 2013 at 11:34 PM

He won. He wants to ride his chariot over the necks of his enemies and glory in their fall. That is what the left understands by “winning”.

David Blue on October 18, 2013 at 2:14 AM

I was thinking on Ronnie’s lines too, until I realized, as did David, that the god-king wanted to show his true contempt for his enemies (those Americans with traditional values, Congressmen who didn’t realised that their role was to fund whatever he wanted, and those who would dare challenge anything he desired). It was more important to him to try to break his opposition than to make a sensible change to his signature program and allow for the proper operations of the federal government.

Kevin K. on October 18, 2013 at 9:40 AM

I honestly can’t understand why obama didn’t offer to “concede” on the delay. It was a gift.

Ronnie on October 17, 2013 at 11:34 PM

Because he absolutely will not allow the Republicans to take credit for doing anything.

Because it would set, in his feeble mind, a dangerous precedent for the Republicans and Congress in general.

Because the HHS goons are telling him in confidence that you can’t pull the individual mandate out without the whole manure pile collapsing. It’s like a house of cards.

slickwillie2001 on October 18, 2013 at 10:22 AM

There needs to be a Republican ad ASAP that says.

You will soon get a letter from your insurance company saying that due to the ‘Affordable Care Act’ your policy is no longer available, but here is a new one that is far more expensive with a huge deductable.

We in the Republican Party predicted this would happen. Here is a list of Republican Senators and Congress persons who voted for Obamacare:

ZERO

Pissed off yet? Call your local Democrat Senator or Congress person and just vent. Go ahead. Tell them how much money their vote is taking out of your pocket.

kurtzz3 on October 18, 2013 at 11:21 AM

Oh that picture……… Says it all. :)

Governor Doofuss, a leading contender for the Dem nomination in 2016.

Another Drew on October 18, 2013 at 2:54 PM

Your emergency triple bypass operation won’t be done until December.

/Obamacare death panel support staff

SparkPlug on October 17, 2013 at 10:06 PM

More like: Due to the Government shutdown our review panel is closed and is unable to determine if your procedure is warranted.

stuartm80127 on October 18, 2013 at 10:38 PM