Are Republican Reps. Andy Harris of Maryland and Jack Kingston of Georgia calling for an investigation into the federal spending on Maryland's Affordable Care Act insurance exchange out of a sincere desire to make sure it works efficiently and effectively? We doubt it. And is Lt. Gov. Anthony G. Brown's campaign spokesman right that Attorney General Douglas F. Gansler's demand for an accounting of the money spent so far on the exchange is motivated by the politics of the governor's race? You bet. But one need not be an opponent of Obamacare to want answers about the decision-making process in the lead-up to Maryland's failed exchange website launch, nor need one be a rival of Mr. Brown's in the governor's race to be curious about what it's going to cost the taxpayers to fix.
The federal government is expected to spend in excess of $200 million by the end of next year on the establishment of Maryland's health insurance exchange, but it has not simply given the state a blank check. The Department of Health and Human Services conducted a number of tests of Maryland's exchange (and all the others it helped fund) during the spring and summer of 2013. The state passed an early test in May and was reportedly the first state exchange to successfully connect to the federal data hub. But a later, more thorough test in late August caused the system to crash with federal officials watching.
It would be worth knowing how HHS officials responded to that failure and what additional oversight they exercised between that test and the Oct. 1 launch date. But that's not a question that is limited to Maryland. According to the Kaiser Family Foundation, the federal government doled out more than $4.5 billion in grants to the states to plan and set up exchanges — much of it spent in states that wound up not creating exchanges at all. Though Maryland's site is considered among the most troubled at this point, it isn't alone; Oregon has had perhaps an even worse experience with its site, and the federal government has already invested more than $300 million there.
Mr. Gansler's demand that Mr. Brown provide an accounting of what the state has spent and will spend on the site comes as the General Assembly shifts its focus from trying to figure out what went wrong to overseeing the O'Malley administration's efforts to fix it. The first hearing of a new legislative committee assigned that task took place on Monday, and Mr. Brown did not attend. Though Mr. Brown's campaign manager, Justin Schall, bristled at Mr. Gansler's demand, saying he was echoing anti-Obamacare Republicans' talking points, Health Secretary Dr. Joshua Sharfstein actually covered much of the substance of the questions on Monday.
The vast majority of the money Maryland has spent to establish its website came from federal grants, Dr. Sharfstein said, and most of the work is covered by a fixed-price contract, so the overruns associated with its problems are not for the most part costing the state more money. However, Maryland has incurred some additional expenses — for example, those associated with increasing the size of its call center beyond what would have been necessary if the website worked well — that Dr. Sharfstein estimated at a bit more than $20 million. Though he did not directly say so, he hinted at the possibility that the state could take legal action against its contractors in an attempt to recoup additional costs.
Dr. Sharfstein said the federal government has, so far, continued investing money in the development of Maryland's exchange despite the troubles but that its willingness to continue to do so is likely continent on the state developing a reasonable plan for how to proceed — whether it be to continue attempting to fix the state's site or by switching partially or entirely to the federal site or to a system developed by another state.
The political purpose of Mr. Gansler's demand is to remind voters that Mr. Brown is ostensibly the administration's point man in the development of the exchange. He released a "Maryland Health Exchange by the Numbers" graphic this week that catalogs the site's failings and, at the end, pointedly notes two figures: 12 ("Number of times Lt. Governor Brown uses the words 'leadership,' 'lead' or 'led' on his campaign's healthcare web page") and 0 ("Number of times Lt. Governor Brown has apologized for the botched rollout of Maryland's exchange").
That's fair game, and it doesn't make Mr. Gansler a cheerleader for the failure of Maryland's insurance exchange or Obamacare generally. Voters deserve to know exactly what role Mr. Brown played in the decisions leading up to the website's launch and what role he is playing now in the decisions about how to fix it.
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