ANNAPOLIS – At 11:14 p.m., less than an hour before the Legislature adjourned for the year, the House Health and Government Operations Committee huddled in the dimly lit lounge behind the chamber.
The group’s leader, Delegate John A. Hurson, D-Montgomery, announced the surprising death of HB 1271, the carefully crafted expansion of health care access.
Other health care legislation faced a similar fate, with several key issues — such as medical malpractice and medical-decision making rights — becoming casualties by Monday’s adjournment.
“Who killed our health care bill?” demanded Delegate Veronica Turner, D-Prince George’s.
The Senate Budget and Taxation Committee destroyed the bill, yanking its support based on funding concerns.
The measure, also known as the “HMO tax bill,” bolstered community clinics to accommodate a Medicaid expansion and upped payments for Medicaid providers. It was funded by eliminating a 2 percent tax exemption enjoyed by health maintenance organizations.
“It is devastating,” said Delegate Joanne C. Benson, D-Prince George’s, a member of the House committee. “It is a blow for those poor families.”
The bill would have garnered federal matching funds for Medicaid, said Delegate Dan K. Morhaim, D-Baltimore County.
Still, money was the main concern of opponents.
Budget and Taxation Committee members said the program could create a huge future deficit, while only addressing a fraction of the state’s uninsured.
And the working poor would foot the bill, said Sen. Gloria G. Lawlah, D-Prince George’s.
Lawlah commended Hurson’s concern, but said the bill “was like sending a mouse out against an elephant.”
Gov. Robert Ehrlich was delighted at the defeat of the tax, which he called “veto bait.”
Health care suffered a second blow with the defeat of HB 1299, the Assembly’s primary medical malpractice reform bill.
The bill, which required mediation in lawsuits and lowered economic damage awards to curb rising malpractice insurance premiums, failed on a tie in the Senate Judicial Proceedings Committee Saturday.
Now Maryland doctors are weighing alternatives.
MedChi, the state physicians’ society, is considering options such as passing surcharges onto patients, carrying less or no insurance and using arbitration contracts that keep patients from suing, said Dr. David Hexter, emergency medicine director at Cecil County’s Union Hospital.
“Clearly, the legislative option is not the answer in Maryland,” said Hexter, who worries about the impact of rising premiums on his hospital group.
Medical Mutual, the state’s largest insurer of doctors, is expected to raise rates as much as 40 percent this year. The state’s second-largest insurer may raise rates by 68 percent.
Lawmakers blamed the bill’s demise on Ehrlich, who circulated a letter of opposition and swayed three Republicans. His more extensive bill containing a cap on pain and suffering damages was rejected by the same committee in March.
“I was shocked,” said Delegate Anthony G. Brown, D-Prince George’s, who led a 15-day House work group to develop the bill. “I was very disappointed that the governor, who didn’t get the whole enchilada in his bill . . . then elected to work against modest reform.”
Chief House bill sponsor Delegate Joseph F. Vallario, D-Prince George’s, agreed, saying “You can’t come down to Annapolis and have a three-hour hearing on medical malpractice and change the world.”
The governor threatened Monday to hold a special session on the issue. Calling lawmakers away from their regular jobs could give Ehrlich an edge to get his preferred reforms passed.
Among the more controversial health-related measures that failed were a series of restrictions to abortions.
Three key bills stalled in committee, including regulation of clinics that provide abortions, prohibition of human cloning and court permission to waive parental involvement in underage abortions. A bill to make fetal assault a crime failed in the Senate earlier in the session.
Same-sex couples and unmarried heterosexual couples were denied medical decision-making rights, after a bill that passed the House in March failed Monday in a Senate committee.
And while it looked like it would pass right until the end of the session, a bill to ask the federal government to waive restrictions on importing prescription drugs from Canada failed. The aim was to obtain medications inexpensively and legally.
The bright spots were few: the General Assembly approved three minor health-care-related bills.
Lawmakers OK’d a bill to improve the availability of medical advance directives, which outline patient health care wishes. And they passed establishment of an Office of Minority Health and Health Disparities.
A bill to ease donation of umbilical cord blood for stem cell research passed.
Lawmakers have promised to revive unresolved issues next year, including expanding health care, medical malpractice and permission for abortions.
“The real issue is how to handle the budget issue, which is going to require that we reevaluate the health care programs and do it in a way that doesn’t hurt people,” said Hurson. “That’s going to be our biggest challenge.”