While legislation calling for the creation of exchanges where the uninsured can easily shop for health coverage has been stalled in Congress and isn't expected this year in the Maryland General Assembly, insurance agents and brokers are girding for the debate.
Major insurance trade groups in Maryland say the state doesn't need a new program, like the one Massachusetts created ahead of federal reform to help provide universal coverage there. Maryland's private sector is equipped to inform and absorb the state's uninsured on its own, according to a report to be released today by the National Association of Insurance and Financial Advisors of Maryland and the Maryland Association of Health Underwriters.
The groups hired an architect of the Massachusetts program to study Maryland's landscape. And while an exchange has been proposed in Maryland before, the report's authors concluded the state's current system already includes intermediaries who can supply information to individuals and small businesses, connect them to coverage and provide them with administrative services such as billing and handling of government subsidies that many newly insured may qualify for - the same functions a new exchange would perform.
"Maryland is well-positioned to leverage the existing private-sector infrastructure rather than expend scarce public resources to establish a new public entity to help organize and structure the market, enhance transparency, improve competition and subsidize the purchase of commercial [health] insurance," the report concluded.
With federal health care legislation that calls for the creation of exchanges on hold, some states are starting to think about what those marketplaces might look like. But the Maryland legislature isn't likely to decide whether to create an exchange during the current session, said Del. Peter A. Hammen, a Baltimore Democrat who is chairman of the Health and Government Operations Committee.
"It really depends on what Congress eventually passes," he said. "We'll be reacting to that."
In the meantime, the state has been working to control costs, leverage federal dollars and shift more subsidies to low-income adults, children substance abusers and other uninsured groups.