ANNAPOLIS – Once again, the General Assembly is being asked to make sweeping changes in the way health care is delivered to tens of thousands of Marylanders without insurance. But with the session barely underway and a new governor sworn in, it is unclear whether 2007 will be a year of significant reform or incremental change.
Delegate Peter Hammen, D-Baltimore, chairman of the House Health and Government Operations Committee, plans to propose legislation packed with a number of options for solving the problem of the uninsured. Rolling all of the proposed remedies into a single bill stands a better chance than proposing multiple bills, Hammen said.
“We’re trying to make health insurance more accessible by making it more affordable,” Hammen said. In a briefing for committee members, he predicted that access to better health care through affordable health insurance would be the “central theme on the committee.”
But Sen. Thomas M. Middleton, D-Charles, chairman of the Senate Finance Committee, says it is more realistic to expect a few changes this year, to be followed by more gradual changes to come.
There is no doubt that health care will be a major issue before the Assembly this year, as it has been for most of the past decade.
Advocacy groups such as the Health Care for All Coalition have become increasingly active and influential, and this month started running radio ads urging Marylanders to contact their legislators about health care bills.
On Wednesday, Gov. Martin O’Malley said the costs of health care are “imperiling the health of working families and threatening the solvency of small businesses throughout Maryland.”
“Working parents shouldn’t have to go begging with a tin cup if their children fall seriously ill,” O’Malley said in his inaugural address.
According to the latest figures, 16 percent of Maryland residents had no health insurance, according to a report by the Henry J. Kaiser Family Foundation.
Hammen said one idea would expand the Medicaid program, a public health program for individuals with low-incomes, by increasing the income eligibility requirement. This means individuals making a little over $11,000 per year would eligible to for Medicaid. Currently, the program covers individuals making about $4,000 per year. The bill would also expand the State Children’s Health Insurance Plan (SCHIP) by covering children whose parents earn up to $39,200 per year.
The proposal also includes a subsidy for small businesses that provide health insurance benefits to low wage workers and would require health insurance providers to cover dependents up to age 25, Hammen said.
“Parents have nightmares about their kids not having health insurance,” said Glenn Schneider, Executive Director of the Health Care for All Coalition. “This is a wonderful way to get them the coverage that they need and the preventive care they need to stay healthy.”
A quarter of the state’s uninsured population earn more than $39,000, and Hammen’s bill would require individuals in this income bracket to buy health insurance or incur a penalty.
Hammen did not specify what type of penalty, but a report from the Department of Legislative services suggests a fine equivalent to the cost of a personal income tax exemption or half the costs of an average health insurance premium.
Hammen proposes to cover the cost with an increase in the cigarette tax and redirect funds from other programs that accomplish the same goals, he said. The $1 increase in on the cigarette tax is expected to generate $211 million during the first year, $170 the second year and continuously decline each following year.
Middleton does not disagree that ambitious plans are necessary.
“We’re coming up with a comprehensive solution,” he said.
But, he cautioned that it might not all come at once. He said it’s more likely that measures such as requiring all individuals at a particular income level to have health insurance and expansion of the SCHIP program are more likely to pass this session.
“If you force people to buy health insurance, they need an affordable plan,” Middleton said.