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Maryland needs a healthcare leader like Sebelius

Here’s an idea for Maryland’s legal money spenders. Instead of rebuilding a state health care exchange, why not join the wildly popular and successful federal exchange. You know, the one that’s projected cost has increased from $900 billion in 2010 to $2.3 trillion in 2014.

Maryland Democrats have already wasted $125.5 million on an exchange they were not technical savvy enough to manage. Now they want to throw at least another reported $40 million into a new exchange—what is that in real money $100 million or more?—to redevelop what the state’s next governor, Anthony Brown, if Democrat bosses have their way, would again lead the nation in implementing Obamacare.

The nonpartisan Congressional Budget Office predicts that health insurance subsidies under Obamacare will total a little more than $1 trillion over the next 10 years, instead of almost $1.2 trillion. CBO said the 8 percent cut results largely from tighter cost controls by insurance companies offering plans on health care exchanges. That is only for insurance not budgetary effects.

The plans offered on the exchanges usually pay health care providers less and have tighter management of patients’ treatment options, and that means lower premiums and taxpayer subsidies. It also means less service. Medicaid adds almost $800 billion in costs over the decade.

“Clearly, the estimate that [] was ready to go Oct. 1 was just flat out wrong,” Health and Human Services Secretary Kathleen Sebelius said on NBC’s Meet the Press April 13. The federal online sign-up system, like Maryland’s, was plagued with technical problems on roll out. President Obama set Dec. 1 as the date to have enough fixed for millions to sign up. It worked.

Maryland officials choose to ignore problems. Their strategy failed – sort of. The political fix seems to be for an oversight committee to issue a report this summer, after Brown wins the Democratic primary and is thereby appointed governor. The report will explain just how badly Brown and others failed.

Lt. Gov. Brown’s big assignment was overseeing Maryland’s preparation for the Affordable Care Act’s rollout in October. It speaks directly to his competence. Sebelius fell on her sword and resigned last week; Brown has blamed vendors. Who is the real leader?

If Maryland persists on its path, the state stands to lose millions more. Retired auditor Charles Hayward wrote a wonkish but fascinating two-part blog on last week. It digs into the details and gives a balanced view on the calamity. If one is interested in how Maryland’s healthcare rollout went wrong, this is the place to read it.

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