The Battle over House Bill 1120 Both business and labor wanted low-cost health insurancefor the thousands of uninsured employees in Maryland.So, why was it so tough to draft a law?

April 15, 1991|By David Conn

It's a miserable snowy January morning, and a handful of reporters has braved the roads and Baltimore drivers to get to the AFL-CIO office near Catonsville, where an unlikely alliance of business and labor leaders has gathered to talk about . . . health insurance.

. The hosts are members of the Baltimore Area Labor-Management Action Committee, the labor side of which is an alphabet soup of local unions: AFL-CIO, UFCW, AFSCME, MSTA, SEIU, UAW and others. It's an odd coalition, with companies such as BG&E, MNC Financial, Bell Atlantic and Westinghouse at the same table as the unions.

The AFL-CIO's Ernest Crofoot, a good-humored bespectacled gent who co-chairs the committee, is uneasy about supporting the proposal, which calls for a lower standard of health insurance coverage than he and the other union members have fought to win from the companies and the legislature.

What they've won are 29 different health benefits insurers are required to offer, including non-controversial coverages such as maternity and newborn care, as well as less frequently used benefits like in vitro fertilization and cleft lip and palate treatments.

But Mr. Crofoot figures the cause is noble: to pass legislation allowing the sale of inexpensive health insurance policies that don't include all the mandated benefits; to make coverage affordable for small businesses that don't offer their employees insurance; and to take a first step toward helping more than a half-million Marylanders who are uninsured.

"This is a very difficult thing for us, because every one of those benefits were supported and necessary, and to relinquish them could be seen as a step backward," Mr. Crofoot says on that January morning. "But when you think that a guy could lose his house because of an appendectomy. . . . We don't want to end up with mud on our face when we're really trying to do something good."

More importantly, the bill is a first step down a three- to five-year path that some legislators and health care experts predict will lead Maryland to an entirely new system of health insurance. Over the next 90 days that vision will move in and out of focus, as lobbyists and lawmakers trip the light fantastic in what Woodrow Wilson called "the dance of legislation."

The labor-management group chooses its partner: Delegate +V Casper R. Taylor Jr., a slow-speaking Democrat with a Western Maryland twang. A veteran legislator, Mr. Taylor owns a restaurant and bar in Cumberland and has a solidly pro-business reputation. Plus, he chairs the House Economic Matters Committee, which will consider the bill first.

Over the course of 90 days, Mr. Taylor will fight for his bill, one of the most important business measures in the 1991 General Assembly session. The battle over House Bill 1120 will be marked by passionate oratory and base greed, by hidden agendas, noble intentions and subtle blackmail.

One legislator will employ a form of hostage-taking -- making the bill's fate contingent on an unrelated piece of legislation. Another lawmaker will use lobbyists as a tool to pressure a key committee chairman.

The odds for passage are long, because health-care providers view the bill as a threat to their livelihoods, and to the standard of health care in Maryland. Dozens of lobbyists will use their influence, often against the desires of the bill's sponsor, to shape the legislation, and such tinkering will boost the estimated cost of an individual policy by almost 15 percent.

But on a bright, chill February morning, Mr. Taylor unveils House Bill 1120 at a news conference in the Economic Matters committee room.

Friendly fire

Almost immediately it comes under a perverse form of friendly fire in Annapolis called "supporting with amendments." At the first public hearing in late February, that phrase is echoed time and again as lobbyists testify how much they like the bill -- except for one or two extra benefits that would improve it immeasurably, and without which they just can't offer their support.

Mr. Taylor calls these efforts "enrichment," and warns that if the special-interest lobbyists are allowed to add more of the currently mandated benefits to the bill, the product could be so expensive it would defeat the original purpose: attracting businesses and individuals who can't afford standard policies. Blue Cross and Blue Shield of Maryland Inc. estimates it can sell a policy to individuals for $85 a month.

But the lobbyists have a good point, too, even if some are being paid well to believe it: A spartan policy that suggests coverage it cannot deliver could be worse than no policy at all.

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