ANNAPOLIS, Md. -- As the coronavirus outbreak worsens, Maryland has reopened its health insurance exchange to boost coverage and expand treatment for the uninsured. The state joins Washington and Massachusetts in offering a special sign-up period while the pandemic continues.

During this crisis, it's essential that all uninsured people get coverage, according to Stephanie Klapper, deputy director at Maryland Health Care for All. She pointed out that a lot of folks without health insurance end up getting treated in emergency rooms, which could create chaos in the middle of a pandemic.

"It's the most expensive place to get health care," Klapper said. "But also, in a public health crisis like this, the emergency rooms could be overwhelmed by too many people needing health care at the same time."

As of Monday, Maryland announced the number of confirmed cases was up to 37.

Signup for the state's health exchange is available until April 15. For more information, visit MarylandHealthConnection.gov.

Twelve states and the District of Columbia operate their own health insurance plans, which Klapper said gives state lawmakers the authority to reopen enrollment in the face of an emergency such as the coronavirus. She said Maryland is the first state in the nation to also have what's called an Easy Enrollment program, which is linked through state tax forms.

"Already 18,000 Marylanders have checked a box on their state tax return to find out their health insurance options and learn how to take the next steps to enroll in coverage," she said. "That program is also still operational."

Klapper said she hopes the federal government will follow Maryland's lead and establish a special enrollment period for the federal Affordable Care Act. Congress has been urging Health and Human Services to deal with this public health crisis by opening enrollment for the 38 states that rely on the federal exchange, but no action has been taken so far.


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Until the pandemic, telehealth and telemedicine were still outliers in health care but they have gone mainstream, especially benefiting underserved and rural New Mexico communities.

Heather Dimeris, director of the Office for the Advancement of Telehealth at the Health Resources and Services Administration, the primary federal agency tasked with improving access to health care services for people who are uninsured, isolated or medically vulnerable, said a national conference being held today will bring public- and private-sector leaders together to discuss topics related to best practices.

"Telehealth licensure, agreements between states to help practitioners practice across state lines, as well as access to broadband," Dimeris outlined. "This is free and virtual and it's open for the public."

Dimeris explained government data show patients who get telehealth services have the same, and in some cases better, outcomes as in-person visits.

Dimeris noted underserved communities often see benefits and improvements in their quality of life through behavioral-health services via telehealth. And those who qualify can leverage the federal Lifeline program, a free government phone service through the Federal Communications Commission.

"Internet is really a foundation of good telehealth services and we can do audio-only appointments, or appointments over the phone, but it's always nice to at least have the video chat," Dimeris pointed out. "That connectivity can be really hard in remote areas of New Mexico."

She added expanding virtual visits could cut down lengthy waitlists for urgent appointments. And she acknowledged many people seeking mental health services prefer to talk with a doctor in order to bypass stigma sometimes experienced with office visits in small communities.

A new analysis from Washington state shows passing an initiative making a long-term care benefit program optional could cost taxpayers millions.

Initiative 2124 would make optional the WA Cares program, in which workers contribute a little more than 0.5% of their paychecks for access to long-term care benefits. The Office of Financial Management estimates passage of the initiative would cost the state between $12 million and $31 million within three years.

Kristin Hyde, press secretary for the group No on 2124, said other analyses have found even greater consequences.

"This initiative would effectively actually end the program, it would shutter it, it would bankrupt the program," Hyde contended. "By 2027, in effect benefits would not be able to be paid out for the nearly 4 million workers who have been vesting in the program."

Supporters of the initiative, including Rep. Jim Walsh, R-Aberdeen, said the program provides little practical effect and people should have choice on whether to contribute to the program. Under the program, Washingtonians will have access to up to $36,500 in benefits from the WA Cares Fund starting in 2026.

Hyde noted the program can be used to pay home aides, for instance, which could help more than 800,000 family caregivers in the state. She added many caregivers are women who sometimes have to choose between work and taking care of family members.

"Long-term care is not covered by regular health insurance and it's also not covered by Medicare," Hyde pointed out. "It's this gap and so we're really in a rock and a hard place here. We don't have anywhere to turn."

Hyde explained it is why state lawmakers approved the WA Cares Fund. She stressed the benefits are flexible and available for use on expenses like home modifications as well.


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Kentucky has made some changes to expand access to free transportation for people who need help getting to medical, dental and mental health appointments, picking up prescriptions and more.

Medicaid's nonemergency medical transportation benefit will now include individuals who own a working vehicle but cannot drive due to a medical condition.

Emily Beauregard, executive director of Kentucky Voices for Health, noted it also applies when using the vehicle conflicts with another household member's need to drive to work, school or their own health care appointment.

"It's going to mean that a lot more Medicaid members will be able to schedule these appointments, make it to the doctor, and not have to schedule everything around when a car or a ride is available to them," Beauregard explained.

If the vehicle is unusable or is unsafe, Medicaid members will need a note from a clinician, employer, school, mechanic, or transportation authority stating the vehicle isn't operable. Nearly 60% of Kentucky Medicaid beneficiaries report lack of reliable and affordable transportation as a barrier to receiving health care services, according to data from the University of Kentucky.

Amber Sparks, a Corbin resident, said she relied on nonemergency medical transportation when her son experienced a mental health crisis requiring hospitalization. She recalled not until she needed nonemergency medical transportation did she realize it was available.

"Another instance that I had to deal with it is that my dad was diabetic, and he wasn't homebound, but he did need daily care and daily back-and-forth to appointments," Sparks recounted.

Beauregard outlined how Kentuckians can find out if they quality for transportation assistance.

"They can call the regional broker in their area," Beauregard pointed out. "If they don't have a car in their name -- or if there is a car, but it's in use for work or for school by another adult in the household -- they should be able to get approved for nonemergency medical transportation."

She added rides can be scheduled with those regional brokers by appointment, Monday through Friday, 8 a.m. to 4:30 p.m., or Saturday from 8 a.m. to 1 p.m., at least three business days before their trip. A list of brokers is online at kyloop.org or by calling Kentucky Medicaid at 800-635-2570. For medical emergencies, call 911.