Three Plans Address Expanding Health Coverage to Maryland’s Uninsured Population

Details about three plans that would extend health coverage to Maryland's 690,000 uninsured residents have surfaced, the Baltimore Sun reports. The three plans will be discussed at a health summit next month sponsored by the Gov. Robert Ehrlich (R) administration and the leaders of the state Legislature. Descriptions of the three plans follow.

• Del. John Adams Hurson (D), chair of the House Health and Government Operations Committee, on Wednesday was expected to release a plan that would expand Medicaid coverage to the working poor by increasing employer contributions and federal matching funds. The plan, modeled after a similar system in Maine, would also build on safety-net clinic services to improve beneficiaries' access to primary care doctors, which Hurson said would help them avoid "more expensive emergency room visits," the Sun reports. The plan, which would be phased in over a few years, would begin with the creation of a Community Health Resources Commission, which could help health centers qualify for federal funding and work to create a system to reimburse specialists who provide care to the uninsured. Hurson would implement a tax on HMO premiums to finance the coverage expansion; Ehrlich last spring vetoed such a plan.
  
  
• The Maryland Citizens Health Initiative is proposing an increase in the cigarette and payroll taxes to expand health coverage to the uninsured. Under the proposal, employers who provide health coverage to their employees would receive tax credits. In a study released at a recent news conference, the group said that expanding health coverage to the uninsured would add 7,000 to 11,000 health care industry jobs. However, increasing the payroll tax would result in 4,400 to 10,300 fewer minimum-wage jobs, according to the group. The plan was first introduced to lawmakers last year but died in legislative committee, the Sun reports.
  
  
• Ehrlich has developed a plan that would use tax credits to subsidize employers that provide coverage to the working poor, the Sun reports. Ehrlich also is considering addressing rising medical malpractice premium costs and ensuring "disciplined use" of the health care system, such as reducing unnecessary emergency room visits, state Health Secretary Nelson Sabatini said. He added, however, that because of the state's budget problems and continuing weakness in the economy, Ehrlich will likely wait to introduce his plan until the 2005 legislative session. In the short-term, Ehrlich will explore "incremental expansions in coverage," including applying for federal support to cover primary care for 17,000 low-income adults, the Sun reports (Salganik, Baltimore Sun, 10/29).