ANNAPOLIS — Two major health care maladies will be treated by Maryland’s legislators when they convene next month for the 416th session: the demise of non-profit health insurance in Maryland, and a budget deficit that threatens Medicaid and mental health programs.
Legislators say CareFirst BlueCross BlueShield’s conversion to for-profit status will be the largest and longest-lasting problem facing the General Assembly next year.
“The major issue is, what’s going to happen to the people they insure now?” said Sen. Paula C. Hollinger, D-Baltimore.
She and other health care specialists are brainstorming ways to safeguard the future of Maryland’s uninsureable – those whom CareFirst had initially agreed to protect.
CareFirst is Maryland’s only non-profit health insurer, and as such is under contract with the state to act as “insurer of last resort” — to enroll, for reasonable costs, Marylanders who can’t get insured by other companies.
Now WellPoint Health Networks, a California-based health care company, wants to buy CareFirst and establish for-profit service in Maryland and Delaware, leaving legislators to come up with an alternate last resort.
“I don’t think we’ll be able to stop (the conversion),” Hollinger said, “but how it’s done will be of major interest to the state.”
In the House of Delegates, legislators are discussing bills to reform the CareFirst entity itself — the General Assembly controls the makeup of CareFirst’s board of directors and can make changes through legislation.
Delegates are also considering ways to tighten the approval process CareFirst will go through in its sale to WellPoint.
Health care organizations say they’ll watch CareFirst developments closely in upcoming months.
“It’s very critical that whatever happens ends up being good for people’s health care,” said Eric Galley, representative for the Maryland Academy of Family Physicians.
Health care activists will also keep their eye on the state budget. With Maryland facing a $268 million deficit by legislative estimates — half attributed to health program funding — and the governor determined not to increase program spending, they’re concerned state health programs may face severe cutbacks.
Legislators are particularly worried about Medicaid and mental health programs, which together account for more than $180 million of the deficit.
“You’ve got a system that’s in basic free fall,” said Delegate John A. Hurson, D-Montgomery, of the state mental health program. “Clinics are closing, people can’t get the services they’re trying to get.”
Gov. Parris N. Glendening has pledged not to make cuts to “critical human services and education,” but health care advocates still fear cuts to these programs.
“I think the question the Legislature is facing, and we always face, is how do you come up with the dollars you need to balance the budget without eliminating necessary health protections?” said Nancy Fiedler, who represents the Maryland Hospital Association.
Meanwhile, some legislators are developing and preparing to back “budget- neutral” health care legislation. Delegate Peter A. Hammen, D-Baltimore, and Sen. Paula C. Hollinger, D-Baltimore, are sponsoring a series of bills to study pain management programs that won’t require extra budget money.
Others are drafting revenue increases to combat the staggering health care deficit.
Lobbyists from the American Cancer Society are hoping a proposed increase in the tobacco tax will look more attractive to legislators and the governor given the state’s deficit. Last year, the tobacco tax was the state’s fifth highest source of income, according to legislative policy analysts.
Also on the minds of lawmakers this session will be bioterror. Both houses of the General Assembly heard testimony during the 2001 interim on the state of bioterror preparedness in Maryland. Legislators say they expect constituents to have concerns in light of this year’s terror attacks.
“Pressure will be on legislators to come to Annapolis, to go back to constituents and say, ‘Yes, we are prepared,'” said Sen. Roy P. Dyson D-St. Mary’s. “And they’re going to want the specifics.”
Public safety concerns may end up bolstering health agendas that have had trouble getting through the General Assembly in years past.
Hollinger’s Nursing Bill of Rights may find extra support with health emergency experts calling for hospitals to expand their capacities — something they can’t do with the state’s nursing shortage.
The Mental Health Association of Baltimore is drafting a bill to create a 24-hour statewide mental health crisis response system, a program Executive Director Linda Raines says would prioritize mental health as a state issue.
Finally, MedChi, Maryland’s physician lobby, may be drawn into the spotlight this year as legislators review the Board of Physician Quality Assurance. The board has come under criticism for a perceived failure to adequately discipline physicians.
MedChi currently plays a role in reviewing physician complaints, but legislators are considering removing them from the panel because they are physician advocates.