Maryland, Washington & Vermont Exchange Updates


In today's speech at the Howard University College of Medicine, HHS Secretary Sylvia Burwell started ramping things up for the 2016 Open Enrollment Season (which I'm gonna designate #ACA2016 unless someone else comes up with something better) by dropping some data points.

Among these was this one: 

Almost half of the uninsured individuals who are likely eligible for Marketplace plans are between the ages of 18 and 34.

This is really important, because only about 28% of those who enrolled in exchange-based policies this year fall into the 18-34 range, which is a problem from an actuarial/risk pool perspective. Younger people are generally healthier, so the insurance companies prefer to have a higher percentage of them in their risk pools in order to help keep premiums/deductibles from increasing too quickly.

If "almost half" of the 10.5 million uninsured people eligible for the ACA exchanges are in the 18-34 range, that's roughly 5 million young adults who the exchanges need to target.

To this end, the Maryland Health Benefit Exchange has decided to stop pussyfooting around and target the youth market with a pretty bluntly-worded blog entry:

Back at college? Get covered for when “Oh, fun” turns into “Oh, F&?$@”

Hey #Classof2019, Open Enrollment for health insurance starts November 1, but you may not need to wait until flu season to get covered.

Plans cover you for medical care like doctor visits, birth control, lab tests and much more. Here are options for college students to be one step ahead of life’s what-if’s:

  • Your college may offer health coverage. If you have a student health plan, in most cases you’re considered covered under the health care law.
  • Stay covered under your parent’s health plan until you turn 26. You can be covered under their plan even if you’re attending school, not living with your parents, or not financially dependent on them.
  • Apply now through Your income may mean you can save money on a health insurance plan, or you may even qualify for free health care through the Medicaid program, with coverage starting immediately. Nine of 10 people who’ve enrolled so far have gotten financial help.
  • If you’re younger than 30, you can buy a Catastrophic health plan through Maryland Health Connection. These plans cost less and protect you from very high medical costs.

Check out our #GetCovered Generation info to learn more about affordable health insurance options for young people.

In addition, the MD exchange announced that they'll be running a pilot program to transfer support calls to licensed insurance brokers, which should ease up their call center load along with other benefits:

The program will reduce Maryland Health Connection’s call-center hold times and will allow consumers to receive plan selection advice, which only licensed agents/brokers can provide (navigators and enrollment assisters are not licensed insurance producers, so they cannot provide plan recommendations).   The pilot program will include 25 brokers during the upcoming open enrollment period, but if it goes well, the exchange is planning to expand the program in 2016.


Last year, Massachusetts and Washington State both attempted to tackle not just the enrollment process, but premium billing themselves. Massachusetts' entire exchange was a disaster; it was scrapped completely and rebuilt from the ground up, and the new one seems to be operating pretty damned well.

Washington, on the other hand, managed to make it through the first and second year with their existing exchange platform. It had/has serious problems, but they were able to muddle through. Their solution to the billing side of things for 2016 is to give up on it completely and move billing back to the insurance companies, as every other state except Massachusetts & Rhode Island does:

Washington Health Benefit Exchange Takes Action to Improve Customer Experience

Customers will now make premium payments directly to their insurance company

The Washington Health Benefit Exchange, which operates the state’s insurance marketplace, Washington Healthplanfinder, today announced that existing customers will begin making premium payments directly to their insurance companies effective Wednesday, Sept. 23, at 5 p.m. At that point, the Exchange will no longer aggregate premiums and cannot accept customer premium payments.

Moving forward, customers will receive monthly invoices directly from their insurance companies as well as important information on payment deadlines, collection policies and grace periods.

Further details for existing and new enrollees are available at the link.


Amazingly, given all of the ongoing technical problems which continued to plague the Vermont Health Connect exchange, it looks like they're gonna pull it together for Year Three after all:

Vermont officials are cautiously optimistic that the state's health insurance exchange will meet next week's deadline for smooth operations.

When Vermont Health Connect launched two years ago it encountered numerous technical, security and operational problems. The state eventually fired its original IT provider CGI and hired Optum to revamp the system.

As of June, the exchange had a backlog of more than 10,000 people trying  to make changes in their coverage.  Commissioner of the Department of Vermont Health Access Steven Costantino says they are on track to clear the backlog and he is cautiously optimistic the exchange will meet its next deadline.   “When you’re doing this kind of transformation there’s possibilities of glitches and tweaks and issues that happen.  It’s almost like you get updates to your phones and your computers and when you do that update sometimes there’s something that happens even though the update was supposed to fix something. And then another update occurs to fix the fix. In a way it’s like that but it’s almost like on steroids because it’s such a big project. We’re cautiously optimistic.  We’re meeting our milestones.  But we also know the reality of this type of transformation and what can happen.”

...Meanwhile, the federal Government Accountability Office last week issued a report on state health insurance marketplaces.  It gave Vermont the highest grades in three of four categories among states operating exchanges.