Health care viewed as key issue in 2008

Reform could be linked to budget deficit package

General Assembly

April 16, 2007|By Laura Smitherman | Laura Smitherman,Sun reporter

The Maryland General Assembly adjourned without approving a multimillion-dollar plan to expand health care coverage to thousands of state residents, but the proposal remains on the table and the drumbeat for universal coverage is only expected to grow louder until lawmakers meet again.

The debate over how to help the growing number of uninsured, a costly dilemma that politicians across the nation are struggling to address, will once again butt up against Maryland's projected $1.5 billion budget shortfall in the next session. But lobbyists and lawmakers say the two issues could work in tandem, with health care as a sweetener in a potentially unpalatable tax package.

Just days after lawmakers departed Annapolis, the idea of a large legislative package is being floated. Such a package would close the budget gap and could include other programs that could be used to draw votes, including transportation funding, the legalization of slot machines and a revamping of the state's outmoded tax structure.

"It makes the sale of a tax package easier," said Sen. Thomas M. Middleton, a Charles County Democrat and chairman of the powerful Finance Committee, where the expansive health care proposal died this session. "It would be a whole lot less offensive for taxpayers if they know part of the funding is going to a health care expansion."

While the legislature did pass some health care legislation, including a measure requiring that insurers cover adults up to age 25 on their parents' policy, they did not approve an expansive proposal to bring more of the state's nearly 800,000 uninsured under Medicaid, the government insurance program for the poor. That plan, which passed the House of Delegates but not the Senate, is considered a blueprint for legislation in the next session.

The rising price of health care has made it a potent political topic, and the possible closure of Prince George's Hospital Center, which has suffered financially as it has cared for a large number of uninsured patients, has underscored the problem. Lawmakers and health care advocates say the number of Marylanders without health insurance could increase by 50,000 in the next year.

Laying groundwork

"What this session did was lay the foundation for a substantial health care expansion in Maryland, and I think that's going to happen the next time the Assembly meets," said Vincent DeMarco, president of the Maryland Citizens' Health Initiative, which has been lobbying for years on the issue. "The Prince George's County hospital disaster illustrates the need for health care coverage."

Gov. Martin O'Malley, who made affordable health care a priority after taking office in January, said he would continue to work with state leaders on finding ways to expand medical coverage but stopped short of endorsing any specific plans for the next session.

"One of my bigger disappointments in the session is that we didn't do more," O'Malley said.

Sweeping health care proposals have been introduced in several state legislatures, including in Pennsylvania, Illinois and California, often running into cost concerns.

"There are a number of states that are going to have a very serious run at expanding coverage," said Ron Pollack, executive director of Families USA, an advocacy group. "This issue is being catapulted toward the top of the domestic agenda."

The debate mirrors one taking place in the nation's capital. Congress wants to expand the government-subsidized insurance program for children in lower-income families, while President Bush has proposed curtailing it as part of a budget-balancing plan.

In Maryland, the financial demands are staggering. In addition to the deficit, health care plans could require as much as $400 million a year in state funds and transportation needs could reach $600 million annually. Even if slots were approved, bringing in as much as $800 million a year in revenue, the amount of money that needs to be raised is significant.

`Gut check' needed

"It's going to take a lot of consensus-building," said Donald C. Fry, president of the Greater Baltimore Committee, a business group that lobbied for health care legislation. "And it's going to take some gut check on the part of elected officials to determine the level of funding that's needed, and whether they are willing to make that tough vote."

House Speaker Michael E. Busch said health care should take precedence as Maryland lawmakers face difficult choices on how to fund pressing issues. He expressed skepticism of a wide-ranging package, saying the logistics would be "daunting."

"The health care problem isn't going to go away; it will only become more of an issue with the average constituent," said Busch, a Democrat from Anne Arundel County. "It's just as pressing a problem as transportation, as our education system."

Baltimore Sun Articles
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.