As Maryland preps for an overhaul of its health care system as part of the national reform effort, officials in charge of the details say the state is in better shape than most others because initiatives have already been launched to cover the uninsured.
The officials, members of the Maryland Health Care Reform Coordinating Council, made the declarations during a meeting Thursday where they presented a general blueprint that discusses programs that exist and a long to-do list.
"We have for years been making investments in reforms to our system," said John M. Colmers, secretary of the state Department of Health and Mental Hygiene and a co-chair of the panel that produced the report. "But there is a lot of work to be done."
The panel was also able to announce Thursday that the state was awarded $85 million in federal funding to immediately insure more people with pre-existing medical conditions. The money was Maryland's portion of $5 billion for the purpose nationwide, and among the federal government's first steps to implement health care reform.
There's no estimate for how many Marylanders will gain coverage, but the state will use the money to expand its high-risk pool that now insures about 20,000 people. It will likely cover a small portion of the 700,000 estimated to be uninsured in the state, or about 15 percent of the non-elderly population. That's slightly below the national average of 17 percent.
Officials acknowledged that covering everyone will not be easy, or initially, cheap — though, like federal officials, those in Maryland believe reform efforts will save money in the long term and improve care for more people.
Lt. Gov. Anthony G. Brown, who co-chairs the coordinating council with Colmers, announced the new funding from the Department of Health and Human Services and said the state will pursue other grants to insure as many people ahead of federal deadlines as possible.
Most of the tenets of reform will not take effect until 2014, such as creation of an exchange where individuals can buy insurance and the subsidies that will help many afford coverage. But Brown pointed to the high-risk pool money as an example of how the state is working with the federal government to temporarily cover the uninsured until the exchange is operating.
"For too long, too many of our most vulnerable residents have been denied health insurance coverage because of the pre-existing conditions that are beyond their control," Brown said in announcing the money. "We can now expand affordable health insurance to our uninsured neighbors – many of whom will have coverage for the first time."
The panel's interim report aims to show other steps that need to be taken now to prepare, such as identifying other federal grants to help pay for coverage, bolstering the medical work force by training more professionals in community colleges and elsewhere, determining what the exchanges will look like and creating pilot programs to test new ways of caring for patients.
One pilot launched in Maryland recently involves recruiting 200 primary care doctors who will agree to provide patients with a "medical home." That means they will offer extra preventive care and help in navigating the complex medical system in an effort to produce better outcomes at lower costs.
After the meeting Thursday, the report will also include 160 ideas from the public, offered on a state website and in testimony at earlier meetings. The panel also agreed Thursday to list six work groups in their report to tackle all the issues. The groups will be open to the public.
That drew praise from Vincent DeMarco, president of the pro-reform Maryland Citizens' Health Initiative. He said the group believes the process has been transparent and productive so far.
He also agreed the state is "ahead of the curve" in terms of implementation because it has already added more young adults to the insurance rolls, offered help to small businesses and is adding low-income parents to Medicaid.
But he would like the state to cover more low-income childless adults. The state had passed legislation to add them in 2007 but then ran into a budget crisis.
"We'd like to see them do a little more ahead of the federal deadlines," he said.
The comments and criticism will be considered by Brown, Colmers and the rest of the panel, which plans to finish the interim report and present it to O'Malley in coming weeks. It should include more details and an estimate of savings to the state by 2020. A final report is to be given to the governor by January.
To see the interim report, go to healthreform.maryland.gov.
