State releases plan to implement health care reform

As Congress considers repeal, Maryland moves ahead with health care reform

January 10, 2011|By Meredith Cohn, The Baltimore Sun

As Republicans in Congress consider a vote to repeal federal health care reform, Maryland officials are poised to begin taking specific steps this year to implement the law.

A panel charged with mapping out reform gave Gov. Martin O'Malley a 16-point plan Monday that recommends creation of a new oversight office and a government body to run the exchange where the uninsured will buy private insurance.

That plan from the Health Reform Coordinating Council estimates reform will save the state $829 million over the next decade and cover about half of Maryland's 700,000 uninsured.

"We continue to be enthusiastic about the projected cost savings to the state of Maryland as we implement reform, and it's a large number," said Lt. Gov. Anthony G. Brown, who co-chairs the council with John M. Colmers, secretary of the state Department of Health and Mental Hygiene.

"Couple that with the report out from the Congressional Budget Office about savings by the federal government and it strongly supports my belief that if we repeal reform we do it at our peril."

The nonpartisan CBO report released late last week estimated that repealing the law would cost the U.S. Treasury about $230 billion over a decade.

Brown and other advocates of reform give repeal little chance of passing Congress.

But Congressional Republicans, who postponed a repeal vote scheduled for Wednesday after the shooting of Arizona Democratic Rep. Gabrielle Giffords, say that the CBO estimates are off.

House Speaker John A. Boehner and other leading Republicans said the CBO was using "accounting gimmicks that mast the true cost to taxpayers," and their own estimates show the health law signed last March would add $701 billion to the deficit over 10 years and 1.6 million jobs would be lost as employers struggle with new mandates and uncertainty.

Twenty states have also challenged the law's requirement that all Americans buy health insurance, and courts so far have given mixed rulings. Maryland is not among the challengers, but Del. Anthony O'Donnell, the Republican leader in state House of Delegates, said lawmakers ought to hold off on implementation .

"We shouldn't push ahead anything that costs money to implement," he said. "We shouldn't hire people and we should spend money because a lot of things are up in the air. We have a deficit, and there is a chance this Obama health care initiative will be defunded or partially or fully revoked or the courts might strike it down."

O'Malley said Monday afternoon that he hadn't yet seen the coordinating council's recommendations and couldn't say which measures he'd support this year, but he said repeal efforts were "a distraction and we should get on with the business of implementation."

The coordinating council spent nine months working on the plan that included public hearings. It did not offer a price tag for implementing the recommendations, but Brown said that no new positions would be created .

Most provisions won't go into effect until 2014, but Brown said he expected at least the exchange to be created this year by the General Assemby.

He said the state also could move forward on other recommendations, which included: applying for all federal money available to build infrastructure; creating a public education campaign; coordinating care for those who remain uninsured; better coordinating mental health coverage with medical coverage; ; and preserving the employer-sponsored insurance.

Ahead of national deadlines, Maryland already has expanded coverage to more than 250,000 residents by largely by expanding Medicaid eligibility.

Officials at the nonprofit consumer group Maryland PIRG and the health care advocacy Maryland Citizens Health Initiative said repealing the reform law would jeopardize these new protections and make health care more costly for many others.

Specifically, PIRG says exchanges that would give consumers bargaining power would disappear and force individual premiums up by 20 percent by 2016. Small businesses would lose tax-credits that make health care costs more affordable.

Employer-based health insurance could jump by $3,000 a year, businesses would create 5,000 fewer jobs by the end of the decade, the state would get $9.1 billion less in federal Medicaid funds and the state's 126 community health centers would be put in peril, PIRG says. Some 18,000 young adults in Maryland would lose the ability to stay covered under their parents' plans.

Baltimore Sun reporter Kelly Brewington contributed to this article.

Health plan highlights

•Create an independent body to run the state's health care exchange

•Maximize federal funding for infrastructure and technology

Coordinate care for those left uninsured

•Coordinate mental and medical health services

•Assess and bolster the medical workforce

•Preserve employer-sponsored insurance

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