ANNAPOLIS – Three major proposals for health care reform – all designed to cut the rising number of uninsured and trim burgeoning insurance costs – emerged from a summit Wednesday in Annapolis.
Gov. Robert Ehrlich’s and state health Secretary Nelson J. Sabatini’s reforms would use a system of tax credits and penalties to assure access to health care for the approximately 700,000 uninsured Marylanders.
Two other proposals, one by Delegate John A. Hurson, D-Montgomery, and the other from Maryland Citizens’ Health Initiative, will also be presented to the General Assembly this spring.
“This is a precursor to a lot of debate and hard work,” said Ehrlich, opening the health care summit in the Senate building here. He outlined eight critical areas the state needs to address including reviewing Medicaid, medical malpractice and access to health care.
Under the Ehrlich administration proposal, private companies would offer a low-cost policy to all employees, and if they could not afford it, they would receive a tax credit.
If employees can afford health insurance, they would have to prove they are insured come tax time or they would be ineligible for a $2,400 state income tax deduction.
“We need to do something about the problem with the uninsured . . . It is not going to be solved in one fell swoop,” said Sabatini.
Many of the uninsured in Maryland are middle-to-high-income working class and 19-to-34-year-olds. Just 20 percent are non-working families, according to discussions at the summit.
“Much of the problem with the uninsured reflects social irresponsibility,” said Sabatini. Those who can afford it, should, he said, and not to do so is irresponsible.
Ehrlich’s plan would also reform medical malpractice insurance. Physicians are having difficulty practicing, especially in high-risk areas, because liability insurance has become unaffordable, said Sabatini.
“I don’t think we can expand access without dealing with medical malpractice,” said Sabatini.
The second plan came from the Maryland Citizens’ Health Initiative, a coalition of more than 1,000 organizations, which called for a cigarette tax increase of 50 cents per pack to generate $100 million for Medicaid reimbursement.
The initiative’s proposal includes a prescription plan that would allow the state to negotiate with drug companies to reduce the drug prices for seniors without drug coverage. A new entity, called MdCare, would also be established to provide health care to people below the poverty level.
“There are a lot of options that are doable from everyone’s perspective,” said Sen. Paula Hollinger, D-Baltimore County. Lawmakers have tucked pieces of reform in all sorts of bills, she said, including her proposal for a school-based health program.
“It’s just a matter of bringing people to consensus,” said Hollinger.
Hurson also presented a reform proposal: The Maryland Community Health Care Initiative, which he said would enlarge the existing “health care safety net” to support the uninsured.
Hurson’s plan would be funded by a 2 percent premium tax on health maintenance organizations – the same tax now paid by other health institutions.
His plan also would shift non-emergency cases from the emergency room to federally qualified health centers. His statistics show about 13 percent of all Marylanders are uninsured, but they account for almost 22 percent of emergency room visits.
“It seems that everyone agrees about the need for comprehensive reform of our state’s health care system,” said Hurson in a written statement. “But there are strong differences of opinion regarding the best way to expand access to health care for lower-income citizens in our state.”