ANNAPOLIS – It’s up to the state to create competitive and affordable insurance programs if all Maryland residents – especially the working poor – are to have adequate health care coverage, says a prominent health care reform advocacy group.
That’s why a state-run insurance program is the keystone of the Maryland Citizens’ Health Initiative plan to establish universal health care coverage in Maryland. The coalition of health care advocates will unveil its plan this morning at the Bloomberg School for Public Health at Johns Hopkins University.
The proposal is the result of several years of preparation and consultation coordinated by the initiative. The group has been meeting with academic and professional advisers from Johns Hopkins University, the University of Maryland and Georgetown University, among others.
Alfred Sommer, Bloomberg School dean, calls the initiative’s plan “the most comprehensive and complete proposal for universal health reform ever developed in Maryland history.”
Parts of the proposal are designed to mirror health care reforms advocated by the Bush administration. These include the proposed expansion of the Maryland Children’s Health Insurance Program and the creation of a pool of funds to help seniors defray prescription drug costs.
But the centerpiece of the proposal is the “Maryland Healthcare Trust,” a state-run insurance program that initiative officials say would establish public accountability for plans statewide and dramatically rework the way insurance claims are handled.
For example, the proposal calls for a web-based claims processing system that would allow the trust to make immediate payments to doctors and other health care providers. Commercial plans now take days or even months to make payments.
The trust also would cover mental health care, drug-addiction treatment, preventative dental care and prescription drug costs.
The group proposes increasing the tobacco tax as part of the plan to finance these changes.
Initiative spokesman Vincent DeMarco says the plan has been criticized as “a stalking-horse for a single-payer approach” to providing health care coverage for all Marylanders. In a single-payer system, all residents would be members of a state-run insurance program without being able to choose another health plan.
“Many people don’t want to be forced into one insurance entity, and we need to build the strongest coalition possible,” DeMarco said.
Instead, the initiative proposal would give employers the ability to select their own employee coverage program as long as the benefits were comparable to those offered by the proposed trust.
The employee coverage, said Pat Schoeni, National Coalition on Health Care spokeswoman, is already in jeopardy.
Part-time and temporary employees could still be left uncovered, she said, under the portion of the plan dealing with self-insured employers.
In addition, Schoeni says the group probably greatly underestimates the cost of coverage for each person.
“What’s going to happen to that trust is, the people who’ll end up being in that trust are all the people who can’t get insurance anywhere else, so they’re probably sicker (than most people),” Schoeni says. “Even if they’ve estimated the cost at around $3,000, it’s probably going to be more than that.”
Other states successfully expanded Medicaid and CHIP coverage, Schoeni said. But states have fallen short in mandating coverage, running up against federal laws exempting certain employers from state universal insurance laws.
The proposal released Friday does not include a recommendation to require health care coverage for all residents. Such a mandate will be included in the second phase, initiative President Peter Beilenson said.
The Maryland General Assembly would likely see the plan in 2003. Officials see next year’s election as an opportunity to attract public attention and make universal health coverage a major campaign issue.
The inititative is one of the largest independent health care reform organizations in state history, with more than 2,100 grass-roots member organizations statewide.
The governor’s office did not return calls requesting comment.