The New Republic

You hear a lot about state officials trying to fight the Affordable Care Act, whether by challenging it in the federal courts or refusing to implement its provisions. But plenty of states officials are enthusiastic about the law. And perhaps none are moving as quickly, or effectively, to follow through on the law as Maryland Governor Martin O'Malley. 

Sarah Kliff has the story in Politico Pro (subscription required):

Maryland has, in some ways, flown under the radar on implementing the Affordable Care Act. It has always been a leader but hasn't racked up any first-in-the-nation accomplishments. It was the third to pass legislation enabling a health exchange, the second to set up an exchange board and one of six states participating in HHS's Early Innovator grant program, for states leading the way on exchange information technology.

But don't count Maryland out - the state has quietly begun moving at a breakneck pace to lay the foundation for a health exchange, movement that has caught the attention of the Obama administration. ...

Gov. Martin O'Malley signed the Maryland Health Benefit Exchange into law in late April and, just a month later, filled out its board with six-appointments, announced here Thursday morning.

The board will host its first meeting June 3 and follow with a second meeting later in the month. The state also plans to apply for additional funding, in the form of a health exchange establishment grant, by the end of the month.

"This is not an announcement and pause for the next step event," Joshua Sharfstein, director of the Maryland Department of Health and Mental Hygiene, said Thursday. "It's an announcement and we're meeting next week. There are places in the country that are not quite amenable to that, but that's not what we're dealing with in Maryland."

In retrospect, Maryland was an obvious candidate to move aggressively on health care reform. It has the right political profile, repeatedly electing liberal officials to both statewide and national office. And it has a history of health care innovation. Its system for regulating hospital prices has gotten a lot of praise from experts who believe it has held down costs without reducing quality or access. 

Still, it helps to have the right people in the right place. O'Malley, who is chairman of the Democratic Governor's Association, is a star on the rise. Anthony Brown, the lieutenant governor, has made health care reform something of a personal crusade, giving a series of well-received speeches about it. Sharfstein, the new secretary of health, was deputy commissioner of the Food and Drug Administration and, before that, an advisor to Congressman Henry Waxman. (Note: Sharfstein is also an old personal friend.) 

Of course, other states are moving forward on health care reform. Among them is California, which I visited earlier this month and about which I will be writing shortly. It's a good case study in what can happen when state officials work with the law rather than against it, although it's also a reminder of just how challenging implementation is even for officials who want reform to work--whether they be in California, Maryland, or any other state. Stay tuned.

Note: Speaking of states working on health care reform, the governor of Vermont just signed a single-payer plan into law. Actually, it's not exactly a single-payer plan, but it's still a really interesting idea. I'll write about that, too, when I get the chance. Yes, there's too much news happening right now--and I'm too slow to write about it all.

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