How are we doing on health coverage, Maryland?

icon-awardMaryland has made great progress as it enters the fourth year of its state-based health insurance marketplace. Let’s count the ways:

1. Continued decrease in the rate of uninsured across the state

Maryland’s rate of uninsured was 6 percent — tied for fourth in nation with five other states as of March 2015, according to Kaiser Family Foundation / U.S. Census Bureau. Also, the large uninsured rate for African-Americans and Hispanics has decreased significantly since 2013, according to research from the University of Maryland School of Public Health in February 2016. Growth in Maryland’s third year of open enrollment ranked third in nation by percentage, according to ACA, up 33 percent to more than 162,000.Enrollment for both private qualified health plan coverage and Medicaid enrollments saw major increases in all regions: Capital-50 percent; Central-85 percent; Lower Shore-102 percent; Southern-102 percent; Upper Eastern-89 percent; Western-65 percent. Dental plans were also offered for first time this year on Maryland Health Connection, with more than 30,000 enrolling. SHOP plans for small business coverage are also seeing growth: More than 1,400 employees and their dependents are covered through SHOP.

2. Making coverage more affordable

Since January 2015, more than 60,000 Maryland households have received a total of $272 million in federal tax credits to help offset out-of-pocket insurance premiums. Nine in 10 Marylanders qualified for financial help to lower or waive the cost of coverage through the state marketplace.

3. Closing the uninsured gap among African-Americans, Hispanics and young adults

Consumers who self-identified as African-Americans on their applications totaled 31,000 this past enrollment season, up 37 percent from 23,000 a year earlier. Prior to that, the uninsured rate for Non-Hispanic Blacks / African-Americans had already been halved from 15 percent in 2010 to 7 percent by 2015, according to data from the Maryland Behavioral Risk Factor Surveillance System (BRFSS), the Maryland Department of  Health and Mental Hygiene (DHMH), the Kaiser Family Foundation and the U.S. Census Bureau, Great progress has also been made in closing the uninsured gap among Hispanics. Consumers who self-identified as Hispanic on their application totaled 19,000 this past open enrollment, up 244 percent from 5,500 a year earlier. The uninsured rate for Hispanics in Maryland dropped from 39 percent in 2010 to 15 percent in 2015, according to those earlier sources. Young adults, another group historically lacking health coverage, have also made strides under the Affordable Care Act. Their participation is vital to the sustainability of these exchanges. Maryland experienced a bump in enrollment of people ages 18 to 34 this year. Young adults now make up 30 percent of private plan enrollments in Maryland Health Connection. That was up from 27 percent a year earlier and now ninth in the nation, according to the Assistant Secretary for Planning and Evaluation (ASPE) of the U.S. Department of Health and Human Services (HHS).

4. Enhanced consumer support

Constituent services unit was implemented in early 2015 to provide additional support for escalated cases. The unit handled 1,900 escalated cases during open enrollment. The Maryland Health Benefit Exchange (MHBE) also introduced the “BATPhone” — more formally the Broker Assistance Transfer program — in which authorized brokers were integrated “virtually” into our call center, Brokers spent 1,000 hours talking to consumers, reducing volumes on call center and resulting in 2,000 enrollments. MHBE also devoted more staff to answer queries across social media, earning special Facebook recognition for a high level of rapid response.

5. Continual website improvements

The system processed twice as many applications during open enrollment for 2016 as it did a year earlier: 525,000 vs. 210,000. Website improvements this year included a more mobile-friendly application and a unique quality-rating star system produced exclusively for Marylanders in concert with the Maryland Health Care Commission. Recent website upgrades include the ability of consumers online to reset their own password and cancel policies. And more improvements are in the works: Results of live user testing conducted toward the end of this past open enrollment is helping guide a process of redesign and other functional changes. The continuing goal is to simplify the experience.