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While the COVID-19 pandemic has posed its fair share of challenges, it鈥檚 also opened the eyes of tens of thousands of uninsured Marylanders, many of whom rushed to enroll in health care plans ahead of falling ill.
Prior to the COVD-19 pandemic, about 6% of Maryland residents were uninsured 鈥� better than the federal uninsured rate, but almost twice the rate of Massachusetts, which holds the U.S.鈥檚 lowest rate of 3%.
It鈥檚 been estimated that about half of those 357,000 Marylanders without health insurance are eligible to enroll through private subsidized plans, Medicare, Medicaid or a combination of the three.
鈥淪till room for improvement,鈥� Johanna Fabian-Marks, director of policy and plan management for the Maryland Health Benefit Exchange, told the House Health and Government Operations聽Insurance and Pharmaceuticals Subcommittee on Tuesday afternoon. 鈥淎nd the easy enrollment program is one avenue to continue making progress in reducing that insurance rate and making sure people are aware of their options for coverage, making it easier for them to enroll.鈥�
Since the Maryland Health Benefits Exchange has been active, several programs have been deployed to further decrease the number of uninsured Marylanders, including the state鈥檚 easy enrollment plan, which gives people the ability to apply to enroll in a healthcare plan when they fill out their tax return.
鈥淓asy enrollment is a really exciting way to reach these folks who are eligible for coverage and may not realize that or may not have taken action to enroll,鈥� said Fabian-Marks.
This year was the first time that the 鈥渃heck the box鈥� plan was in effect. And 53,146 of the nearly 61,000 people to check the box confirming their status as an uninsured individual were deemed eligible to register. About 17% applied and just 8% ended up enrolling, which Fabian-Marks called 鈥渞eally remarkable.鈥�
鈥淲e鈥檇 like to see that higher, of course 鈥� that鈥檚 a big drop off from 53,000 to 4,000 鈥� but for 鈥� just checking a box and then we sent them a letter, I think that鈥檚 quite a successful conversion rate,鈥� she said.
But there are other programs that have eased the pain of seeking out and paying for health insurance, too.
The Maryland Health Benefit Exchange鈥檚 reinsurance program slashes the cost of health insurance premiums in the individual market by聽covering portions of insurers鈥� claims. In turn, these lower premiums mean that the federal government pays less to subsidize insurance for people earning up to 400% of the federal poverty level.
The federal government then passes the money it saved on to the state health benefits exchange to fund Maryland鈥檚 reinsurance program.
According to Fabian-Marks, individual market premiums will be down nearly 12% and lower than the national average by 20% to 30% in 2021.
鈥淚ndividual markets premiums have continued to fall,鈥� said Fabian-Marks. 鈥淲e鈥檝e really seen great success in the reinsurance program.鈥�
And as premiums have gone down, the number of people enrolled through the reinsurance program has been on the rise. At the end of the 2020 open-enrollment period, enrollment saw a four-year high.
鈥淲hat we鈥檙e seeing this year, largely [and] unfortunately due to the impact of COVID, has been enrollment has really been surging over the course of the year,鈥� Fabian-Marks explained to the sub-committee.
Because of COVID-19, the state鈥檚 open enrollment period and the deadline to file taxes were extended, allowing more eligible individuals to 鈥渃heck the box鈥� or apply through the reinsurance program.
During the special enrollment period, which began in March and lasts through Dec. 15, Fabian-Marks said that over 93,000 people have signed up for health insurance coverage.
鈥楢 very, very good鈥� vetoed bill
Maryland鈥檚 Prescription Drug Affordability Board is wrapping up its first 鈥� and very challenging 鈥� year of operations.
鈥淭he [Prescription Drug Affordability Board] currently exists, but we didn鈥檛 have any operating funds,鈥� said Van Mitchell, the chair of the board.
During the truncated 2020 legislative session,聽聽sponsored by House Speaker Adrienne A. Jones (D-Baltimore County) was put forth that would have provided the board with a funding formula outside of the state budget.
鈥淲e felt like we had a very, very good bill,鈥� Mitchell said to the subcommittee.
Jones鈥� legislation passed in both the House and the Senate but was vetoed when it reached the governor鈥檚 desk.
This led Mitchell to negotiate with the Governor鈥檚 Office for permission to seek funding through the Maryland Healthcare Commission or the Health Services Cost Review Commission until the board could get a funding formula bill passed.
According to Mitchell, the board ended up having just $12,000 in expenditures this year, paid for by the Healthcare Commission. He said that projected spending for 2021 will 鈥渉opefully鈥� include staffing, contracting with analytical firms and office space.
The Board is hoping to have $750,000 allotted in the next fiscal year to conduct its operations.
鈥淚 don鈥檛 think we鈥檒l spend the $750,000 in the current year, but we鈥檒l certainly spend more than $12,000,鈥� said Mitchell.
The board鈥檚 projected five-year budget includes expenditures of just short of $1 million each year.
COVID-19, the state鈥檚 hiring freeze and the lack of a funding stream have slowed down the board鈥檚 work, but they have managed to hire one contract worker and an executive director with permission from the Department of Budget Management.
They are now working with the Department of Health, the Maryland Healthcare Commission and the Department of Budget Management to finalize the hiring process.
鈥淎s soon as we know something from those three agencies and [get] a total sign off, we鈥檒l [be] more than happy to send you a notice and announce who the executive director will be,鈥� Mitchell told the subcommittee.
