ANNAPOLIS -- A plan to take Maryland one small step closer to a comprehensive reform of its health-care system cleared its first major legislative hurdle yesterday.
The bill in itself is a modest reform aimed at making health insurance more affordable by more evenly spreading the risk among small companies, those least able to offer coverage to their workers.
But the legislation, known as "small group market reform," is considered the second step toward what some hope will emerge as a system that provides affordable coverage to the estimated 640,000 Marylanders who have no health insurance at all.
"I am still going to predict that we will pass a piece of legislation that will create a systemic reform in Maryland within the next two to three years," one that provides universal access and contains skyrocketing health-care costs, said Del. Casper R. Taylor Jr., D-Allegany, chairman of the House Economic Matters Committee.
The lawmakers voted unanimously yesterday to send the bill to the full House, which will consider it by the middle of this week.
The first step toward fundamental health-care reform came when the General Assembly passed a law last year that allows insurers to sell a "limited benefits policy" to small companies, one that doesn't offer all of the more than two dozen benefits the state requires for most health insurance policies.
Insurers had said they could sell such policies for 30 percent to 40 percent less than traditional coverage. By making available a less expensive policy, last year's law is intended to attract some small employers who couldn't otherwise afford to offer coverage to their workers.
Some critics have complained the minimal policy is both too expensive to meet its goal and too skimpy to provide adequate coverage. Blue Cross and Blue Shield of Maryland Inc. last fall became the only insurer to introduce such a policy; the company hasn't yet reported how many it has sold.
Small group market reform goes a step further by requiring guaranteed access to health insurance for all small companies -- those with 25 or fewer employees -- and guaranteed coverage for every individual in those companies, regardless of their health.
The bill allows insurers to wait 10 months before covering a pre-existing medical condition, but after Aug. 1, 1997, that limitation will be prohibited entirely. The bill would diminish the often vast differences in health insurance prices charged companies based on the age, health status and gender of their employees, a company's location and its industry.