It should surprise no one that Medicaid is the most out-of-control item in the embattled Maryland state budget. Enrollment in the welfare program jumped from 370,000 to 423,000 in just one year -- another grim result of economic hard times. State Health Secretary Nelson Sabatini does not exaggerate when he warns that "Medicaid, if it keeps going in the direction it is going, will drive states into bankruptcy."
It is virtually certain that as health care costs rise, so will demands on Medicaid. In a nutshell, here's what is happening: A worker at a plant like Bethlehem Steel gets laid off, losing health-care benefits. The worker takes temporary work or a lower-paying job with inadequate benefits, or none at all. The worker's family postpones doctor's visits until an illness becomes severe enough to require hospitalization. A single hospitalization soon bankrupts a low-income family. The worker then applies for Medicaid. That's more or less what happened to 6,000 Marylanders who made applications for Medicaid this past month.