The year of public health in Md.

December 02, 2007|By Vincent DeMarco

The people of Maryland should be very proud of their leaders for making 2007 the year of public health in Maryland, which despite its wealth has traditionally been among the worst states at providing health insurance for poor adults.

The General Assembly this year passed four new laws, which will:

Require all workplaces and public places to be smoke-free.

Increase the state tobacco tax by $1 per pack.

Allow young adults to stay on their parents' insurance plans.

Provide health care coverage for many lower-income adults.

Data from across the country make it clear that increasing tobacco taxes and requiring all workplaces and public places to be smoke-free significantly reduce smoking, particularly among children, and save many nonsmokers from illness and death caused by secondhand smoke.

The Campaign for Tobacco Free Kids estimates that Maryland's $1-per-pack cigarette tax increase will deter more than 50,000 children from smoking, one-third of whom would have died from tobacco-related illnesses. This estimate is based on experience in many states with tobacco tax increases, including Maryland's 30-cents-per-pack increase in 1999, which resulted in about 20,000 fewer kids smoking.

During this year's regular session, the Assembly enacted a law to allow young Marylanders to stay on their parents' health insurance plans until age 25. While about 15 percent of all Marylanders are uninsured, about one-third of young adults have no health coverage because many have trouble finding first jobs out of high school or college that provide health care. By allowing young adults to stay on their parents' plans while they find their way in the job market, this legislation could substantially reduce the number of uninsured.

Finally, and most significant, during the recent special session, the Assembly passed Gov. Martin O'Malley's Working Families and Small Business Health Coverage Act, which will provide health care coverage to more than 120,000 lower-income Marylanders through grants to small businesses and expansion of the adult Medicaid eligibility level.

Although Maryland has long been one of the best states in the nation for guaranteeing health care for children, its record on health care for lower-income adults has been dismal. As a consequence, it has a very high rate of uninsured people, and we all pay higher insurance premiums to cover the uncompensated cost of their hospitalization.

By increasing the Medicaid eligibility level for adults to 116 percent of the poverty level, the new law will ensure that people who can't afford private health insurance have the health care coverage they need. It will also decrease the burden on our hospital emergency rooms - a burden that raises everyone's insurance premiums. According to a study by Families USA, the total employer and employee cost of a family of four's health insurance premium includes about $1,000 a year to pay for health care for the uninsured.

There is, of course, more work to be done. In addition to statewide smoke-free laws and tobacco tax increases, states that have significantly reduced smoking have also funded their tobacco prevention and cessation programs at levels recommended by the Centers for Disease Control and Prevention. Maryland should do the same. And even after our new health care law is fully implemented, there will still be hundreds of thousands of uninsured Marylanders whose health will suffer and whose finances could be destroyed by unexpected illnesses or accidents. We must continue to work toward our common goal of quality, affordable health care for all.

The Rev. Martin Luther King Jr. once said, "Of all the forms of inequality, injustice in health care is the most shocking and inhumane." Mr. O'Malley and the Assembly have taken a major step toward lessening this shocking and inhumane burden for many Marylanders. Let's keep working together to make Dr. King's dream of a healthy society for all a reality.

Vincent DeMarco is president of the Maryland Citizens' Health Initiative, which advocates for laws to improve health and health care coverage. His e-mail is demarco@mdinitiative.org.

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