Helping more addicts

Gov. Martin O'Malley has come out in favor of expanding Medicaid eligibility for poor people, a move that could result in the provision of more drug treatment. That would be a welcome development, allowing more addicts to get treatment as well as better health care.

Maryland has a serious health care problem, including close to 800,000 people who are uninsured. Although the problem must be addressed through a variety of solutions, expanding Medicaid coverage needs to be part of the mix. The state's current salary threshold is only $6,288 a year for a working parent in a family of three. Although Mr. O'Malley has not yet come up with a specific proposal, his endorsement of the idea could make a tremendous difference in the General Assembly, where a bill to increase eligibility passed the House but failed in the Senate during the last session.

Expanding Medicaid eligibility would necessarily include some who are addicted to drugs or alcohol, perhaps as many as 10,000 people in Baltimore alone. Despite a $5 million increase in state support in the current fiscal year, demand for treatment continues to outstrip supply.

In addition to dealing with addictions, more generous Medicaid standards would also give substance abusers better access to general health care, including treatment for chronic diseases. Even though coverage might be limited by managed-care providers, addicts would still fare better than not being seen by a doctor at all. And the public health care system could provide better oversight of providers through increased reporting and communication that would come with increased patient loads.

Medicaid is certainly not the answer to the state's need for more drug treatment; one key drawback is that Medicaid generally provides only outpatient care. But using more Medicaid dollars - which are matched by the federal government - for outpatient treatment could free more state dollars for costly residential treatment. A state-funded drug treatment system is still necessary, but reaching more addicts through Medicaid is a smart way to go.