As one of thousands of uninsured Marylanders, Adamantious Boulis put off trips to the doctor to treat his diabetes and colon cancer because he knew he wouldn't be able to pay the medical bills.
Now he is faced with more medical problems - yesterday, he was back at Johns Hopkins Hospital, waiting for biopsy results.
Only this time, he and his wife are less worried about the bills: They are now eligible for Medicaid under an expansion of the state's health insurance program for the poor that takes effect today.
"They should have done this long ago," said his wife, Alanna Boulis. "It is nerve-racking, especially for him. I worry more for him than for myself."
The Medicaid expansion is one of several measures enacted in the past eight months that state officials say will eventually take more than 100,000 residents off the uninsured rolls.
The patchwork of health care measures has a cradle-to-grave effect - not only bringing more children and families into Medicaid but also helping small businesses to provide employees with coverage and seniors to buy prescription drugs. Other bills aim to regulate pharmacy benefit managers, possibly leading to lower drug costs.
With little federal action to establish universal health care, states have taken the lead in efforts to expand coverage in recent years. Maryland's new laws don't take the state as far as Massachusetts, which established universal coverage two years ago through a combination of subsidies, mandates and the creation of a new health insurance exchange.
But state officials say the bills are a crucial first step toward making sure all Marylanders have access to care.
"This moves Maryland back into a leadership position that we had ceded for some time," Maryland Health Secretary John M. Colmers said of the package of new laws.
"While it does not solve all of the problems, it does make a major dent in the number of uninsured. Until the federal government acts, we are going to have to look for making important incremental changes when we can."
About 800,000 residents, or 14 percent of the state's population, lack health insurance. While Maryland has one of the most comprehensive Medicaid programs for children, it ranked among the most limited in terms of eligibility for adults.
That meant that heads of households like Alanna and Adamantious Boulis were able to get care for their children but not for themselves.
