Marc Kilmer's piece in the June 13th edition of The Sun ("Maryland should go slow on establishing a health insurance exchange") misses the boat completely on why Maryland needs to move forward on creating a health insurance exchange. Under the leadership of the O'Malley/Brown administration, Maryland has been a consistent leader on health care, taking the state from 44th to 14th in the country in health insurance for low-income residents, and covering over 250,000 parents, children and seniors. Covering more residents benefits everyone, reducing the costs we all pay for care for the uninsured.
By being an effective leader once again and setting up the exchange early, Maryland is poised to cover more of our fellow citizens. As Mr. Kilmer recognizes, every state is required to establish an exchange by 2014 under the Affordable Care Act. If the state fails to do so, the federal government will do it for us. So the question is whether we want the federal government to create our exchange or whether we want a Maryland solution, with Maryland leaders addressing a Maryland problem. I think it's best to solve our health care problems here at home.
By being a leader and creating our exchange early, the state is also in the position to win significant, time-limited federal grants to move forward, therefore not relying on state funds to get our exchange up and running.
Waiting to implement the exchange, as Mr. Kilmer suggests, would squander this opportunity and could easily cost the state a lot more in the long run. This is an important point to consider in light of our current delicate fiscal situation.
Mr. Kilmer might be correct when saying that the Connector in Massachusetts, like everything in our health care system, is not perfect, but it did provide eye-opening lessons for the rest of the nation. As we move forward with a Maryland exchange, we can replicate the benefits of the Massachusetts Connector and avoid repeating its mistakes. Further, Mr. Kilmer failed to note that Massachusetts' Connector enjoys great public support and has reduced the uninsured rate in the state to lower than 3 percent — by far the lowest rate in the nation.
Mr. Kilmer also fails to take into account that before the Affordable Care Act was even passed, Maryland was already leading the way in health care.
Many provisions of the new law were already established as part of Maryland health care policy, such as legislation that allowed young adults to stay on their parents' health insurance until age 25, grants to help small businesses provide health care to their employees, and a major expansion of our Medicaid program to help support working families that were losing their jobs and their coverage in the economic downturn.
With this solid foundation to build upon, it makes sense for Maryland to take the lead on implementing federal reform. Implementing the Affordable Care Act in a timely manner will make Maryland programs even stronger and put an end to critical barriers, which Mr. Kilmer fails to mention, that prevent many Marylanders from accessing affordable coverage: Marylanders can currently be turned down for coverage or charged more in premiums due to pre-existing conditions — practices that will be prohibited in 2014 thanks to the Affordable Care Act. Maryland has always been a leader in health care and should continue to make sure we expand coverage to Maryland's 750,000 uninsured through swift implementation of the Affordable Care Act.
It would be a mistake to end Maryland's tradition of leadership on health care. We have an Administration of proven health care leaders, a public health virtuoso health secretary, and an exchange board comprised of some of the country's finest minds. With this team we will build an exchange that will control costs, cover more Marylanders, and make sure that every Marylander has access to quality, affordable health care. The time to act is now.
Matthew Celentano, Baltimore
The writer is deputy director of the Maryland Citizens' Health Initiative.