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Here’s why Maryland needs a Basic Health Plan

Washington Post
February 22, 2018
Op-Ed-Delegate Robbyn Lewis

Health care is a human right. Without universal access to quality, affordable health care, nothing else matters. Children need good health to learn and grow, and working adults need it to be engaged, creative and productive citizens.

Unfortunately, Republicans are using their control of the federal government to rip health coverage away from the American people. Their efforts to destroy the Affordable Care Act, also known as Obamacare, threaten hard-won gains for health coverage and drive up costs — so much so that even with generous ACA subsidies, many people find healthcare prohibitively expensive. Costs have risen even more, thanks to Republican-led efforts to eliminate the coverage mandate. Working people are rightfully anxious.

The first line of defense to protect health care for millions of Americans falls on the states. We have the power and opportunity in Maryland to defeat destructive efforts emanating from Congress and the White House.

First, we can protect basic coverage, which many of my colleagues in the Maryland General Assembly are determined to do. Second, we can close the affordability gap, which is what I’m fighting for.

The affordability gap for health coverage is real and working families are suffering the most. It’s those who do not have employer-sponsored coverage and who earn too much to qualify for Medicaid but not enough to pay for ACA plans. We all have a friend or family member who, despite working every day, has suffered because he or she couldn’t afford to pay for health coverage.

One of those hard-working people is my sister: A former journalist and published author who graduated from law school in 2009 during the worst global economic disaster since the Great Depression. She is proof that in today’s economy, an advanced degree doesn’t guarantee long-term employment or a livable, reliable income. For years, despite working in a range of contracted, no-benefits legal jobs, she earned too much to qualify for Medicaid but couldn’t afford a private plan.

Without health coverage, she had to choose between buying groceries or paying exorbitant prescription costs for a chronic illness. After the ACA became law, she was relieved to finally receive coverage. Ultimately, though, those contractor positions were too inconsistent to earn enough to afford that plan. Over the years, her illness has grown worse because she could not afford coverage. As with thousands of hardworking Marylanders, my sister was trapped in the affordability gap.

My sister’s story is not unique. Almost 250,000 hardworking people across Maryland are in the same situation. These folks — entrepreneurs, artists, single moms, your neighborhood barista — all deserve more.

I am a public health professional who worked at the Maryland Health Benefit Exchange, and my commitment to health care as a human right is unwavering. That’s why I’ve introduced legislation to create a Basic Health Plan.

The Basic Health Plan will ensure that folks trapped in the affordability gap — those who earn between s$18,000 and $24,000 for a single person and $50,000 and $58,000 for family of four — will have access to vital coverage without making impossible choices. This plan is an option available to states under the ACA. Minnesota and New York are the only states to implement BHPs so far. I want Maryland to be the next.

New Yorkers covered under BHPs pay no more than $20 in monthly premiums for plans with $0 deductibles. In just one year (2015-2016), an additional 58,000 hardworking New Yorkers enrolled in BHPs.

The Basic Health Plan directs existing ACA federal subsidies to pay for more coverage. BHPs are special because they have low monthly costs that are within the means of hardworking people who, like my sister, have modest incomes.

My bill calls for a study to determine how Maryland can pay for the Basic Health Plan using federal subsidies which have already been earmarked for health coverage under the ACA. If there’s no additional cost to the state, the policy will be implemented immediately. The goal is to expand coverage while containing out-of-pocket costs and feasibly roll out BHPs for those caught in the affordability gap.

Our state has been at the forefront of health system innovation for decades. This plan is in keeping with our values and priorities. It aligns with our commitment to earned sick leave. And it is strengthened by our commitment to protect Marylanders from federal efforts to undermine health care for all.

Access to good health care should never be an issue of affordability. I’m fighting for your friends and family, to protect the right of every Marylander to access healthcare.

Robbyn Lewis, a Democrat, represents the 46th District in the Maryland House.