Maryland health insurance marketplace: history and
news of the state’s exchange

BCBS of Maryland and Bright Health offering plans for 2018; cost of CSR added to silver premiums,making other
metal levels particularly affordable

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Louise Norris
Individual health insurance and health reform authority; broker
March 22, 2018

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    • Insurance for those over 64

Highlights and updates

  • 2018 enrollment down 4.6% from 2017
  • One insurer in 2017, but Bright Health joined in 2018
  • Average rate increase 15.6%, including added premiums to cover CSR cost
  • Cost of CSR added to silver exchange, other metal levels particularly cheap for some
  • 2018 rates and new insurer indicate death spiral no longer a danger

Maryland exchange overview

By the end of the open enrollment for the 2018 year, 153,571 residents had enrolled which was 2.6% lower than the previous year. However, thanks to the Affordable Care Act, the number of residents who are uninsured has declined dramatically. In 2013, 10.2% of residents were living without health care and in 2016, the number declined to 6.1%.

Maryland Health Ratings

On the 2017 Scorecard on State Health System Performance, Maryland tied with New York coming in at 10th place. The state ranked highest in Access category. Only 1% of individuals under the age of 65 had high out-of-pocket medical costs.

2018 Enrollment Rates and Carriers

For 2018, CareFirst and Kaiser are still offering plans but Cigna withdrew at the end of 2017. However, Cigna only had a small market, with only 700 members. In 2016, Maryland Health Connection launched a new program where customers who called the exchange could then be transferred to brokers for assistance. The goal behind this new program was to reduce call-center hold times as well as increase customer satisfaction. A total of 162,177 people enrolled in qualified health plans in the 2016 open enrollment. This was a 35% increase from the previous year and the 3rd highest percentage nationwide. As for 2018, 153,571 people have purchased a health care plan.

Maryland and Medicaid

The Kaiser Family Foundation estimated the 756,000 nonelderly Marylanders were uninsured. After Maryland decided to expand Medicaid, 302,400 residents qualified for coverage through the program. Maryland saw a 53% increase in Medicaid enrollment from 2013 to 2017. Nationwide, the Medicaid enrollment is 29%.

Risks in Maryland

The Maryland Health Insurance Plan was created in 2003 to give those with pre-existing medical conditions another options. However, the plan has now been eliminated due to the Affordable Care Act and the need for high-risk pools has been eliminated.


Medicare in Maryland

Nationally, about 17% of the population is enrolled in Medicare. In Maryland, 16% of the state’s population is enrolled in Medicare. Maryland has a smaller percent of Medicare enrollees who qualify due to a disability, about 14%. Annually, Medicare spends about $9,190 per Maryland enrollee. About 52% of Maryland Medicare recipients have a Part D plan which covers prescriptions.


Through Michigan’s state-federal partnership exchange, they have ten carriers offering individual health care plans. On average, rates have increased an average of 16.7%. In comparison, plans have increased 25% nationwide. Michigan dropped from 15th place in 2009 to 31st in 2015 by the Commonwealth Fund’s Scorecard on State Health System Performance. They got to the top 10, coming in at #6 for its low percentage of uninsured children and ranked 13th for its percentage of uninsured adults. Furthermore, Michigan ranked 35th in United Health Foundation’s America’s Health Rankings in 2015. The state ranked low in categories such as: preventable hospitalizations, public health funding, and childhood immunization.



Rates and Carriers

At the end of the 2016 open enrollment, 345,813 people had purchased health insurance plans. Of those participants, 33% were new and 84% received subsidies. The following carriers and their rate increases for the 2017 are:

  • Blue Care Network: 14.8 percent
  • Blue Cross Blue Shield of Michigan: 18.7 percent
  • Health Alliance Plan: 16.8 percent
  • Humana: 39.2 percent
  • McLaren Health Plan: 12.2 percent
  • Meridian: 9.3 percent
  • Molina: 3.2 percent
  • Physicians Health Plan: 6.7 percent
  • Priority Health (HMO): 13.9 percent
  • Total Health Care USA: 7.2 percent


Michigan and Medicaid

Michigan was among the states that chose to expand their Medicaid to residents who had income levels up to 138% of the federal poverty level. People who earn between 100-138% will be required to pay premiums equal to 2% of their household income, they can apply for the state plan Health Michigan. All beneficiaries contribute to a ‘MI health account’ to pay their copayments and those copayments are reduced for health behaviors. From 2013 to 2016 Michigan Medicaid increased 20% to more than 2 million enrollees per year.

Medicare and Michigan Nationwide, 17% of the population is enrolled in Medicare. In the state of Michigan, 19% (or 1.9 million) of the state has enrolled in Medicare. The program spends about $9,555 per enrollee each year. 32% of Medicare enrollees chose a Medicare Advantage plan. Around 58% of Michigan Medicare recipients have enrolled in Medicare Part D plan which provides prescription drug coverage.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.