For many months, it seemed as if Maryland was off on a small island as it took steps to ready for national health care reform. In fact, almost immediately after President Barack Obama signed the health care law on March 24, 2010, the state began preparations, at Gov. Martin O’Malley’s direction.
Some critics and skeptics said Maryland should slow down. Largely Republicans, they said that Democratic state officials were racing ahead with health care reform in blind support of Obama’s plan. They argued that the state should wait to see what the U.S. Supreme Court, which was weighing the fate of the federal law, would rule.
Last week, the nation’s high court, in a 5-4 decision, upheld almost all of the Patient Protection and Affordable Care Act.
A key component of the act requires states to establish a health benefit exchange, to be operational by Jan. 1, 2014. The exchanges are to offer consumers a choice of plans, set up rules regarding offerings and pricing and serve up information so consumers could make wiser decisions about their health care options.
In the 2011 General Assembly session, lawmakers mandated the Maryland Health Benefit Exchange. Lt. Gov. Anthony G. Brown championed establishment of the exchange. Four advisory committees were charged with making recommendations to the legislature by the end of 2011 on what plans should be offered outside the exchange, how much choice employees should have, user and licensing fees, how to make it self-sustaining by 2015 and how to prevent waste.
This past May, O’Malley signed the Health Benefit Exchange Act of 2012 into law. Officials expect the state’s exchange to provide health care access to more than 146,000 people when it begins operating. Eventually, they hope that more than 350,000 Marylanders will be covered. Under the plan, which remains a work in progress, individuals and small businesses will take part in a single marketplace. “Navigator” programs will be formed to make it easier for people without health insurance to determine whether they qualify for plans and to move from one plan to another. The Maryland Health Care Reform Coordinating Council is required to choose the state’s benchmark for plans in the exchange.
In contrast to Maryland’s lockstep adoption of federal health care reform, officials in a number of states, including neighboring Virginia, dragged their feet. They hoped that the court would overturn the law. Now, those states are scrambling to draft their plans or face having to adopt a federal health exchange model.
Some die-hard opponents of so-called ObamaCare still hold out hope that Republicans in Congress or Mitt Romney, if elected president, will succeed in getting rid of at least elements of health care reform.
Whether they got lucky or were prescient, Maryland officials — from the governor on down — were prudent in pressing ahead with the state’s portion of health care reform.