Maryland Governor Might Expand Medicaid To Cover Low-Income, Uninsured Adults

Maryland Gov. Martin O'Malley (D) is considering the possibility of expanding Medicaid coverage to more adults, a move that could cost the state millions, despite a projected $1.5 billion state budget shortfall, the Baltimore Sun reports. According to the Sun, Maryland "is one of the leading states in covering children" through SCHIP, but "the parents of those children are rarely eligible for Medicaid," and childless adults cannot qualify for the program unless they are blind or disabled.

O'Malley has not offered a detailed plan for expanding Medicaid, but he said he supports the concept while exploring solutions to close the budget shortfall. O'Malley also said he would like to make insurance more affordable for small businesses. John Colmers, state secretary of health and mental hygiene, is developing low-, medium- and high-cost options for expanding Medicaid and other health care changes affecting quality and affordability.

According to Colmers, making health care coverage more affordable without changing Medicaid would not allow the state to achieve universal health access. Colmers said that even if the state increased the minimum Medicaid income eligibility limit to 120% of the federal poverty level, low-income state residents are "not working in jobs that are likely to have health insurance. Or if they could purchase insurance, they couldn't afford it. All their income would go toward health insurance," adding, "There is no private-market solution."

However, state Sen. E.J. Pipkin (R) said expanding Medicaid would be "expensive, and there's also the question of the quality of care people receive under the Medicaid program." He added, "The goal should be that people make their own decisions about their own health care rather than have the government make decisions for them." Critics also say that "it makes no sense to expand one of the biggest reasons for the state's precarious financial position, particularly given more innovative health care expansion plans that have been tried in other states" and offer consumers more varied and affordable choices than Medicaid does, specifically the one established in Massachusetts, the Sun reports.

Del. Peter Hammen (D), chair of the House Health and Government Operations Committee, said Maryland's gap in coverage for low-income adults is far greater than Massachusetts', which would make it more difficult for lawmakers to create programs to meet their needs (Green, Baltimore Sun, 8/12).