When Leadership Fails
Once upon a time you’d get an editorial from the Baltimore Sun that made sense (usually it was somebody from Red Maryland who wrote it) but this morning’s stinker on the Maryland Health Care Exchange was particularly egregious.
The argument from the editorial board is that Maryland’s decision to abandon our own exchange to throw in with the flawed Connecticut exchange is a decision that we should stick with, even in light of continued dollars and resources down the drain trying to fix their flawed software.
Of particular interest is this:
Nonetheless, it prompted Republican gubernatorial candidate Larry Hogan to issue a news release blasting Maryland’s Obamacare implementation. Insofar as he used the opportunity to criticize his Democratic opponent, Lt. Gov. Anthony G. Brown, the O’Malley administration’s supposed point-person on health care reform who has been altogether absent from efforts to fix Maryland’s insurance exchange website mess, it was entirely reasonable. Inasmuch as it suggested the state should be doing something different now, it wasn’t. Mr. Hogan reiterated his call for the state to forget about Connecticut and instead use the federal exchange. That was probably bad advice when Maryland made the decision to adapt Connecticut’s software in April; it’s definitely bad advice now.
The Sun’s evidence for as to why abandoning the Connecticut software for the federal exchange is……sketchy:
The federal government doesn’t charge states to use heathcare.gov, but switching Maryland to it wouldn’t have been either automatic or free. An analysis presented to the health benefits exchange in March estimated that it would cost as much as $10 million. But there was a big caveat: Maryland (along with all other states) needed to upgrade its Medicaid eligibility and case management systems to conform with the Affordable Care Act, and the federal exchange does not include that functionality. Maryland would have to build it separately, at a cost consultants estimated at about $46 million. And given that Maryland’s previous system was two decades old and had not been significantly upgraded in recent years (it’s programmed in COBOL), that figure might have been conservative; Virginia, for example, expects to spend more than $75 million to finish the task.
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This is part where the Sun’s argument finds it’s fatal flaw. Their argument, in a nutshell, is that there are costs associated with states using the federal exchanges, and that it is a better value to invest in a state-specific exchange rather than update existing software.
But you have to take a step back and look at the costs of the upgrade versus the costs associated with exchange development. Assume that Maryland spent $75 million to upgrade its Medicaid exchange, as was done in Virginia. That is still over $50 million less than Maryland has spent so far ($129 million and counting) with no working product to show for it on a project that was savaged by Legislative Auditors. And that doesn’t even count the $40-50 million final tab for using the Connecticut software.
Had Maryland upgraded the existing Medicaid software in the first place instead of Martin O’Malley trying to be a leader in state exchanges in an effort to boost his Presidential campaign, the state would have saved at least $100 million so far. And have a working health care exchange.
But the Sun’s oddball vision of the health exchange extends even further, into a realm in which they would rather see Marylanders denied access to care than find a viable solution:
A spokesman for Mr. Hogan pointed out that we were enrolling people in Medicaid long before the Internet and could do so again. But that’s not a long-term solution. The Affordable Care Act requires online Medicaid enrollment as an option, along with electronic verification of things like income eligibility. Even as a stop-gap for this open enrollment period, it wouldn’t be wise; analysts estimate that creating an interim paper enrollment system would cost $5 million to $10 million, and then the state would still have the expense and challenge of developing a permanent software upgrade.
Yes, paper enrollment would be a stop-gap for this open enrollment period. But The Sun, long champions of this cockamamie Obamacare scheme, would rather that the administration throw good money after bad towards online solutions that may or may not work instead of taking proactive steps to actually get people covered. Something which is not happening.
The fact that the Sun editorial board is giving political cover to the O’Malley-Brown Administration is of course nothing new, but this editorial shows how far that they will go to defend the failed leadership in Annapolis. One of the critiques that The Sun and other “mainstream” media outlets have of Republican candidates is that our candidates never offer solutions. In this case, Larry Hogan is offering a solution which is simple, clear, effective, and affordable. And instead of embracing that solution, The Sun and others attack it because it does not embrace the pre-existing technological boondoggle that could have been easily avoided had the O’Malley-Brown Administration been responsible stewards of state tax dollars in the first place.
No Republicans are fans of Obamacare, and no Republicans that I know of don’t want to see it repealed so that other health care solutions can be rolled out. Unfortunately, we’re stuck it until a Republican Congress can repeal it and go back to the drawing board. But what the O’Malley-Brown Administration has done with the exchange and their lack of leadership and management oversight on the tax dollars being spent to implement it are shameful and scandalous. It’s what happens when leadership fails. And the fact that The Sun wants to give them political cover to continue to waste taxpayer dollars and take steps to ensure that people don’t have access to the health care coverage Obamacare is supposed to provide is shameful too.