Health care or stall

February 09, 2007

The contrast between the Maryland General Assembly's two chambers has seldom been more obvious. On Wednesday, House Speaker Michael E. Busch and Del. Peter A. Hammen, chairman of the House Health and Government Operations Committee, announced their support for legislation that could reduce the number of uninsured by a quarter-million, or nearly one-third of the state's total. That could help contain health care costs for all consumers.

And what was the reaction of top leadership across the hall in the state Senate? A declaration that the bill is - in the vernacular of hospital emergency rooms and backroom politics - dead on arrival.

Senate President Thomas V. Mike Miller objects to using the $1 increase in the tobacco tax on expanded health insurance coverage - as proposed in the bill - instead of applying it toward reducing the state's growing budget deficit. On its face, this is a respectable argument - at least for passing a cigarette tax as soon as possible.

But this isn't what Mr. Miller wants at all. The Senate president's fixation is not on the deficit and certainly not on the pressing issue of Maryland's 800,000 uninsured citizens. He wants the legislature to approve slot machines at racetracks, and he's frustrated that neither the House nor Gov. Martin O'Malley seems interested in taking up his cause.

In fact, Mr. Hammen's bill might even help reduce the deficit by providing a way to finance one of its root causes - the rising cost of Medicaid. The state budget can't (and shouldn't) be balanced by the tobacco tax. For starters, it doesn't raise enough money. But more important, it's money that ought to be used for health care - addressing a need that tobacco so clearly exacerbates.

Maryland voters elected a slate of Democrats last fall not because they expected "racinos" but to improve the state's quality of life and put an end to the "drift of recent years," as Mr. O'Malley described it. By expanding Medicaid eligibility, offering subsidies to small businesses that provide workers' health insurance and mandating that families of four earning $82,800 buy insurance, the House bill does just that. The sooner the cost of providing emergency room treatment for the uninsured is addressed, the sooner everyone else will no longer have to foot the bill for this uncompensated care through higher premiums.

Lawmakers are welcome to tinker with this proposal. Whether a smaller tobacco tax increase or a stronger mandate is required is open to debate. But to hold such a critical initiative hostage to slots is simply nonsensical. The House has taken the lead on health care reform. Now it's up to the Senate to offer more than a roadblock.

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