Mr. O'Malley's opportunity

March 20, 2007

By a lopsided vote last Friday, the House of Delegates approved a bill to dramatically reduce the number of Maryland residents without health care insurance - a proposal financed mostly by doubling the state's tobacco tax. It's a bill that would put Maryland on the map in terms of health care reform. Even skeptics suspect that a majority of senators would vote for the bill if they had the chance.

But it's unlikely they will get it. Senate President Thomas V. Mike Miller is adamantly opposed to raising the cigarette tax by $1 a pack - at least for this year. He says the state should be solving its long-term budget problems first. While that's a laudable goal, one can only wonder about its authenticity. It's well established that Mr. Miller would like to see slot machines at Maryland racetracks and sees any revenue bill that's not tied to that effort as problematic.

There's plenty of room for compromise here. The Medicaid expansion required by the legislation could be reduced and a portion of the tobacco tax used to balance future budgets. But Maryland's nearly 800,000 uninsured don't seem to have triggered much sense of urgency within the Senate's leadership. And Gov. Martin O'Malley, apparently content to put all his revenue proposals in a single basket next year, appears willing to let the proposal die for now.

That's a discouraging prospect. It's time the governor applied pressure to the Senate president on the issue of health care reform. Voters didn't elect Mr. O'Malley last November because they wanted another four years of can't-do governance.

Raising tobacco taxes to pay for health care isn't some wild-eyed left-wing cause; it's a national trend. The legislature in Iowa passed a $1 tax increase last week. Governors in such moderate states as Maine, Wisconsin, Indiana and Delaware have proposed similar measures. Charging an extra dollar per pack would give Maryland the nation's fourth-highest cigarette tax (tied with Michigan and Arizona), but that's nothing to be ashamed of - on the contrary, the public health benefits of that alone make it worthwhile.

Passing real health care reform would also give the governor something to herald in the legislative arena. While he has proved decisive in administrative matters, Mr. O'Malley's cautious approach with the General Assembly is in danger of leaving him with relatively few accomplishments this session, aside from the "clean car" initiative (a retread from previous years) and his one-year college tuition freeze that's helpful but hardly a legacy. Mr. Miller's single-minded devotion to slots shouldn't be allowed to stymie serious health care reform.

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