It seems fitting that a state whose postal abbreviation is the same as the one for “doctor” should be the first to consider scrapping its failed health insurance exchange. An editorial at the ultra-liberal Baltimore Sun (h/t David Freddoso) lays out the gloomy dilemma Maryland faces: whether to try salvaging its under-performing exchange or be absorbed by the equally glitchy federal exchange. Talk about having to decide between a headache and an upset stomach!
[T]he pace of enrollments is still far too low. If the exchange is able to replicate its best weekday and weekend performance during every one of the 104 days between now and the end of the open enrollment period on March 31, Maryland will still only achieve about three-quarters of its goal of signing up 150,000 people with private coverage. The site may be better, but better isn’t good enough.
Under those circumstances, the question raised by Rep. John Delaney, a Montgomery County Democrat, about whether it would be better for Maryland to scrap its effort to build its own exchange and instead join the federal one has merit. Indeed, Gov. Martin O’Malley acknowledged on Monday that the option — and all others — remain on the table.
That’s a hard possibility for Governor O’Malley to acknowledge. Under his leadership, Maryland was one of the most aggressive states in the effort to build out its own exchange — a strategic decision that appears in retrospect to have involved no small amount of hubris and political ambition. Walking away now from all that effort and tens of millions in expenditures would be particularly embarrassing. [Emphasis added]
It would also have policy implications. Maryland decided to build the kind of exchange it did because officials wanted to create something of a one-stop portal that would integrate shopping for private plans and enrolling in Medicaid…. The state also had designs on eventually integrating enrollment for other social services — like food stamps and energy assistance — into one system. Scrapping the state exchange altogether would ensure that none of that would be possible, at least not anytime soon.
[…]
Both the governor and Lt. Gov. Anthony G. Brown indicated on Monday that they are open to all options. They need to be. We can’t let pride or momentum get in the way of doing whatever it takes to make sure Maryland residents can sign up for health insurance as soon as possible. After all, despite the political overtones, that’s what this is about.
The highlighted phrase applies equally well to the administration’s refusal to delay the rollout of Healthcare.gov, despite warnings months earlier that the site was not ready for prime time, and its reluctance to bring in tech experts from the private sector, fearing that doing so would be seen as a repudiation of the public sector’s boast that it could perform as well if not better.
Fredosso notes that Oregon is another state that is in desperate straits but hasn’t yet entertained the possibility of abandoning its exchange. Oregon, too, is facing its share of hubris, though it is dealing with it in a fairly non-constructive, as Joe Newby noted yesterday. To wit, Cover Oregon has insisted that its “community partners” sign an agreement that forbids them from criticizing the state’s Obamacare exchange.
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