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Health exchange working, on surface

(Nov. 21, 2014) It may be too early to declare a “smooth rollout” of Maryland’s health exchange system this week, but it already appears to have gone better than last year, at least at first glance.

The Maryland Health Connection website opened for enrollment on Tuesday, one day earlier than planned, and will stay up through the end of open enrollment on Feb. 15.

“It’s been performing pretty well,” Andrew Ratner, director of marketing and outreach for the Maryland Health Benefits Exchange, said Wednesday. “The site has been digesting most of the applications today, which is the first official day it’s open to the public. As of this morning, we probably completed 2,000 applications so far.”

This is in comparison to the roughly 300 applications processed in the first week last year, when technical difficulties plagued the rollout of the state’s previous website.

But some insurance brokers are still finding that the premiums the new site spits out are not in line with what they should be under federal guidelines.

“Our first application was giving an individual a $511 subsidy each month, but they should’ve been getting $250,” said Chris Keen of Keen Insurance in West Ocean City. “If that were to go through on the federal side, that person would owe over $3,000 at the end of the year on their tax returns.”

This year, Maryland is using an entirely new website and database borrowed from Connecticut, one of the few other states in the U.S. that has elected to run its own insurance exchange network. The alternative option would be for the states to pay the federal government to include them on the national healthcare.gov website.

Health exchange systems are the key feature of the federal Affordable Care Act, often referred to as “Obamacare.” By subscribing to the exchange, people who are uninsured or under-insured by their employer can pool their buying power to purchase their own private insurance plans, many of which are subsidized by the federal government.

Although Tuesday was the first day the general public could access Maryland’s sign-up site, the system has been open to authorized insurance brokers since last week.

Some improvements of the Connecticut system over Maryland’s in-house software were evident, but some issues on the back-end could take time to be fully realized, Keen said.

“The problem is that no one at the state is going to know right away if it’s wrong,” he said. “What I don’t’ want to do is put in an application that’s wrong and have it never get processed.”

Because of the changeover in systems, all 72,000 Marylanders who signed up last year will need to sign up again, on the new system.

The formula used by the health care act to determine how much exchange plans will be subsidized with federal dollars is relatively complex, and takes into account a number of modifiers to the standard IRS income determination.

“It could be that somebody has more tax deductions than normal that may affect that formula,” Ratner said, in reference to issues with the site’s preview feature earlier this year. “But since the site has fully launched, what you see online should be an exact replica of what you get.”

Subsidy levels change with the amount of coverage a person buys, and with how their income compares to the federal poverty line. Anyone making less than 400 percent of the poverty line will receive some type of discount, depending on the level of coverage they select.

In Maryland, anyone making less than 138 percent of the federal poverty line will be enrolled in Medicaid.

“Right now, we’ve seen the system give Medicaid to people above 138 percent,” Keen said. “There shouldn’t be any reason for that difference.”

Across the nation, many additional Obamacare signups are expected in the coming weeks. For 2015, the federal government has increased penalties for individuals who do not carry health insurance, up to two percent of adjusted gross income on their tax filing.

Employers of a certain size are required by the act to offer a certain level of coverage to employees, who are not eligible for subsidized plans on the exchange if they have a qualified “affordable plan” through their employer.

Only businesses with 100 or more full-time or equivalent employees – calculated by adding up total hours and dividing by 120 hours per month – must provide insurance. Next year, all businesses with more than 50 will fall under the requirement.

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