Caring first

March 30, 2003

MARYLAND STEELWORKERS, who contributed so much to the building of America, are leading the nation down another arduous path. They are in the vanguard of American workers and retirees on the verge of losing their employer-subsidized health insurance.

But the politicians rushing to their aid should be looking for solutions with wider application. Given the state of the economy and the growing cost of health care, this is a problem that likely won't end with the financial collapse of Bethlehem Steel. Already many airline workers have lost jobs, health benefits or both.

State officials would be wise to anticipate these needs with a comprehensive approach. This looks like an ideal assignment for CareFirst, as Maryland's BlueCross BlueShield health plan returns to its nonprofit mission of serving as many people as possible at the lowest possible price.

Bethlehem Steel retirees now appear likely to retain at least some of their coverage through a patchwork of rescue efforts.

Sen. Barbara A. Mikulski helped push through Congress last year legislation that requires the federal government to pay 65 percent of the premium costs for retired steelworkers too young to qualify for Medicare, which begins at age 65. The Maryland General Assembly, with the support of Gov. Robert L. Ehrlich Jr., is arranging for those retirees - about 25 percent of the 20,000 retired steelworkers in Maryland - to purchase their insurance through a new Maryland high-risk pool with the help of the 65 percent federal credit.

As welcome as this relief may be for the steel retirees, federal premium subsidies are not a viable remedy for the legions of workers who may face similar circumstances.

Another provision of the state legislation would help steel retirees 65 and older by ensuring they have access to insurance coverage sold as a supplement to Medicare - so-called Medigap policies, which may or may not have prescription drug coverage. Some Beth Steel retirees may also qualify for limited drug benefits through a state program for the low-income elderly.

Again, these are helpful measures but part of a makeshift solution that would be hard to apply more broadly.

Ms. Mikulski calls it only a first step.

The next step is more difficult. CareFirst officials, facing reorganization by the legislature after a failed bid to shed their nonprofit status, aren't rushing to offer broad coverage to high-risk steel retirees. Perhaps they can't without taxpayers or other insurance customers shouldering some of the burden. But allowing a large segment of the elderly population to go uninsured doesn't come cheap, either, and those same groups wind up paying the bills.

This is exactly the kind of health insurance crisis Blue Cross health plans were created to address. Once CareFirst leaders shake loose visions of those million-dollar bonuses they lost, surely a creative solution will emerge.

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