$15.5 Billion Plan Would Raise Taxes to Cover the Poor

By Lisa Rein
Washington Post Staff Writer
Thursday, November 13, 2008; B05

Maryland health advocates unveiled a $15.5 billion proposal yesterday for universal health care that would subsidize insurance coverage for low-income residents with a payroll tax and increases to cigarette and alcohol taxes.

The Maryland Citizens Health Initiative also calls for mandated coverage for those who do not get it through their employer. The group pledged that the policies would be more affordable than they are now.

The coalition of labor groups, churches, businesses and community organizations consulted with health policy experts from the University of Maryland, Johns Hopkins University and the Robert Wood Johnson Foundation.

The plan aims to build on two programs the General Assembly passed last year, an expansion of the federal-state Medicaid program for the poor and subsidies to some small businesses to help them afford insurance.

But lawmakers and even the advocates acknowledged that the plan has no chance for passage soon.

"We don't expect it to pass in 2009," said Vincent DeMarco, president of the nonprofit Baltimore-based group. "This is the beginning of a campaign."

DeMarco called the plan a way to "make quality health care affordable to all, especially small businesses" and said his group will focus in coming months on building public support for it.

Del. James W. Hubbard (D-Prince George's) is expected to introduce a bill in the 90-day legislative session that begins in January.

Del. Peter A. Hammen (D-Baltimore), chairman of the House health committee, said the General Assembly has little appetite for costly programs in the current economy. But he said the plan "gives energy" to efforts to pass ambitious health-care legislation in a state with an estimated 700,000 uninsured residents.

The plan would allow small businesses and individuals to join an insurance pool, giving them leverage to negotiate lower rates for policies than on their own. Maryland would go into the insurance business, covering the costs of catastrophic care to lower premiums. To contain costs, patients would face higher co-payments for less effective and more expensive procedures.

A 2 percent payroll tax would be levied on all businesses, and the tax on cigarettes would jump to $2.75 a pack from $2 and alcohol by a dime.

The National Federation of Independent Business, a lobbying group representing small companies, said in a statement that higher payroll taxes would drive businesses out of Maryland.

By Laura Smitherman

November 12, 2008

Health care advocates plan to unveil today an ambitious $15.5 billion proposal for universal health care in Maryland that would increase payroll taxes to pay for coverage for low-income residents and create a quasi-governmental insurance pool.

The Maryland Citizens' Health Initiative, with health policy experts from the Johns Hopkins University and the University of Maryland, crafted the proposal. The groups plan to build a coalition of labor unions, faith groups and community organizations. Del. James W. Hubbard, a Prince George's County Democrat, said he will introduce the bill in the legislative session that begins in January.

But such a proposal faces an uphill battle, since State House leaders are confronting budget shortfalls and some policymakers are talking about rolling back previous health care expansions.

In a statement, the National Federation of Independent Business, which represents small companies, called the plan "a massive state takeover of the health care industry." The group said higher payroll taxes would hurt a weakened economy and drive businesses out of Maryland.

But advocates were undeterred.

"We know it's going to take a while for this to become a reality," said Vincent DeMarco, head of the health initiative.

Hubbard said that pieces of the proposal could be passed over several years. The last expansion, which made more Marylanders eligible for Medicaid and created insurance subsidies for small businesses, was scaled back before winning approval.

The latest proposal would create a health insurance pool for coverage of individuals and employees of small businesses, offer reinsurance that covers high-cost care, further extend Medicaid eligibility and subsidize premiums for low-income residents.

The total cost to the state was estimated at $15.5billion over five years.

Small Business Owners & Health Care Consumers Unveil Plan to Make Quality Health Care Affordable For All

Comprehensive proposal would make quality health care affordable for all state residents 

Baltimore, Md. – Small business owners and health care consumers unveiled today a plan to make quality health care affordable to all at the Johns Hopkins Bloomberg School of Public Health. The proposal emphasizes helping small business owners purchase insurance for their employees. It is supported by a broad coalition of business and consumer interests, spearheaded by the Maryland Citizens’ Health Initiative.     

The plan was crafted with the help of health policy experts from Johns Hopkins University and the University of Maryland and builds on progress made previously in Maryland to expand health care coverage. In November 2007, Gov. Martin O’Malley signed the Working Families and Small Business Coverage Act into law, which guaranteed health care for over 100,000 uninsured Marylanders and helps small businesses access affordable health care policies. While many people have benefited from this legislation, there remain more than 775,000 residents of the state who have no health insurance.  

The proposal introduced today would provide increased access to care in Maryland by reducing excessive administrative costs and improving the quality of care received in Maryland. The plan would give relief to business owners who are trying to provide employees with affordable health care by creating a Maryland Health Insurance Pool – a ‘marketplace’ for individuals and small businesses to purchase quality insurance at reasonable costs. The plan would help reduce excessive administrative costs that individual and small group policyholders pay by pooling the highest risk patients across the broadest number of people. Those with low and modest incomes would receive a subsidy to purchase insurance. 

“We’ve been working for more than two years on a plan that makes quality health care affordable for all, particularly small businesses and families,  in a way that is politically viable and fiscally responsible,” said Vincent DeMarco, president of the Maryland Citizens’ Health Initiative. “Too many businesses are having trouble keeping up with escalating health care costs, and as a result, too many Maryland families live each day without health insurance and face the consequences of poor health and personal bankruptcy if they get sick. This new plan allows our friends, family members and neighbors who are uninsured to get much-needed coverage. Small business owners, the employers for so many of the uninsured in Maryland, shaped this proposal and share our commitment to Maryland continuing to be a national leader in health reform.”   

The plan is funded through a two percent payroll tax, matching funds from the federal government, funds from existing public programs for the uninsured, increasing the state alcohol tax to a ‘dime a drink’ and the cigarette tax an additional 75 cents, and increasing taxes on non-cigarette tobacco products.

More than 150 organizations have already endorsed the proposal, including leading faith, medical, community, labor and consumer organizations, along with many Maryland small business owners.  

“There are hundreds of thousands of Marylanders that do not have the resources needed to receive quality health care when they need it,” said Bishop Douglas Miles, past president of Baltimore’s Interdenominational Ministerial Alliance. “In order for our citizens to be healthy and our businesses to thrive, they need our help. Supporting this proposal is a top priority for us in the next state legislature.” 

The plan would use available federal funds to expand Medicaid eligibility to include parents whose household income is up to 300 percent of the federal poverty limit – about $63,000 for a family of four – so they can be insured by the same plan as their children, who are already covered under the program. In addition, it would expand Medicaid eligibility to non-parents with incomes up to 200 percent of the federal poverty limit – $20,800 for individuals, $28,000 for couples.  Other aspects of the proposal:

• Emphasizing Quality and Efficiency – The plan includes prevention and public health promotion programs and improves the efficiency of the health care system by giving incentives to hospitals and doctors who adopt electronic health records.
• Catastrophic Reinsurance – The proposal includes a state-wide plan for the sickest, most costly health care cases (those with costs over $35,000), by pooling the costs of these cases among all privately insured Marylanders and allows for more efficient management of these cases. 

To read more about the Maryland Health Care for All! plan, click here

Gov. Martin O'Malley and Baltimore health advocates announced the launch yesterday of a $150,000 advertising campaign designed to let uninsured Baltimoreans know that thousands more of them are eligible for Medicaid.

Under a law that went into effect in July, parents with annual incomes up to 116 percent of federal poverty guidelines, or about $20,500 for a family of three, are now eligible for Medicaid. Before the new guidelines were passed, only parents making less than 40 percent of poverty were eligible.

"It's not enough just to pass a law. ... We have to do the outreach," O'Malley said at a news conference outside a social services center in Pigtown.

The "Got Healthcare?" campaign features the Democratic governor and four Ravens players. Radio spots featuring O'Malley and Ravens safety Ed Reed will be heard on five area radio stations. Print ads will also run on more than two dozen billboards, 53 buses and 30 bus shelters.

In the radio ad, O'Malley and Reed encourage listeners to call 311 to determine their eligibility.

Also yesterday, O'Malley and Comptroller Peter Franchot mailed 10,000 letters to Maryland families eligible for the Medicaid expansion. Nearly 500,000 will eventually get letters.

Health Secretary John M. Colmers said the state can pay for the expansion for two years without taking money from the state's general fund. After that, Colmers said, funding will be linked to the success of November's slot machine gambling referendum.

Tuesday September 23, 2008

Ads to tout health care coverage expansion

Ravens team with state, health advocates to tell uninsured about expanded Medicaid eligibility; Continued expansion could depend on slots

Sean R. Sedam | Staff Writer

BALTIMORE Gov. Martin O'Malley stood alongside state and city officials, health care advocates and members of the Baltimore Ravens on Tuesday to unveil a new advertising campaign aimed at getting more Baltimore city residents enrolled in health coverage through the Medicaid expansion that went into effect in July.

The $150,000 campaign includes radio spots featuring Ravens safety Ed Reed and O'Malley encouraging city residents to call 311 to learn more about coverage eligibility. They will air on five Baltimore radio stations.

Twenty six billboards around the city, and posters on buses and at bus shelters will feature Ravens players and encourage residents to call or go to www.bhca.org to get enrolled.

Despite the state's budget crunch, expanding Medicaid coverage was "the right thing to do," said O'Malley (D), who spoke outside Paul's Place, a soup kitchen and community outreach center in the Pigtown/Washington Village neighborhood were many residents lack health care.

The expansion will save all Marylanders money by decreasing the cost of uncompensated care of uninsured people that those with insurance pay as part of their premiums, the governor said.

"We spend and waste so much money because working people do not have health care coverage so they can get the preventive care," he said. "And as a result, guess who pays? We all pay when people have to become so sick, when their children have to become so sick that they have to be hospitalized."

The General Assembly passed the expansion during the 2007 special legislative session called by O'Malley to close a $1.5 billion budget gap.

It expands eligibility to parents making less than 116 percent of federal poverty guidelines, or up to $20,500 for a family of three.

The expansion will take Maryland from 44th to 21st in the nation in insuring adults.

The state has already enrolled 11,283 people in the expansion since it took effect July 1, including 2,945 Baltimore city residents.

Letters were mailed to 10,000 eligible families on Monday.

The expansion package also included $15 million in subsidies for businesses with from two to nine employees whose wages are below $50,000 a year to provide coverage.

Nearly 800,000 Marylanders lack health coverage. The next — and more difficult — step toward reducing that number is phasing in eligibility to childless adults between fiscal 2010 and fiscal 2013.

With the economy in a tailspin and the General Assembly facing a projected $1 billion deficit by fiscal 2010, some have said that it could be too big of a step.

In July, Senate Finance Chairman Thomas McLain Middleton (D-Dist. 28) of Waldorf said the expansion to childless adults could not happen unless the state voted to legalize slot machine gambling.

"There's a strong argument to be made that this really saves us dollars over the long term," O"Malley said. "There's a big decision coming up on the slots referendum. That's certainly something that I hope people will vote in favor of.... It's a big chunk of what allows us to maintain fiscal responsibility and continue to make this sort of progress and maintain efforts like this."

O"Malley stopped short of tying coverage of childless adults to passage of the Nov. 4 ballot question.

 "But I will say this: Without the approval of the referendum, if we don't keep those Maryland dollars that are currently going to Pennsylvania, Delaware and West Virginia, in Maryland, it makes all of our progress more difficult," he said. "Progress in health care, progress on affordable college, progress in maintaining the huge investment we've made in public education."

GOVERNOR O’MALLEY TO JOIN BALTIMORE RAVENS TO UNVEIL MEDICAID EXPANSION AD CAMPAIGN

Ad Campaign Encourages Baltimore City Residents to Call 311 for Eligibility   

BALTIMORE, MD – Governor Martin O’Malley will join the Baltimore Ravens, the Health Care for All! Coalition and Baltimore Health Care Access on Tuesday, September 23rd at 2:00 p.m., to unveil a new ad campaign to encourage eligible Baltimore residents to enroll in the new Medicaid Expansion.  

The campaign is sponsored by Baltimore Health Care Access and Maryland Health Care For All. Governor O’Malley and the Baltimore Ravens will also be joined by Department of Health and Mental Hygiene John Colmers, Baltimore City deputy Mayor Janie McCullough, Baltimore City Council President Stephanie Rawlings-Blake, Baltimore City Health Commissioner Josh Sharfstein, Maryland AARP Director Joe DeMattos, and other health officials. 

WHEN:          
Tuesday, September 23, 2008                         
2:00 p.m.  

WHERE:  
Paul’s Place
1118 Ward Street
Baltimore City, MD 21230  

Hear the radio ad (mp3)
See the Billboards

Medicaid reaches more

Maryland is patching together expanded coverage for the low-income uninsured

By Laura Smitherman

Sun reporter

July 1, 2008

Insuring the uninsured

Our view: Health of Maryland's poor gets a needed boost this week

June 29, 2008

Joanne Hohman is slowly losing the use of her knees but can't afford a specialist to diagnose exactly what's wrong. Her husband, Richard, recently suffered chest pains and may have sleep apnea but can't pay for the test to confirm it.

Living on less than $20,000 a year, the middle-aged Catonsville couple has been forced to neglect a variety of ailments, from high blood pressure to asthma. They are two of the estimated 800,000 Maryland residents who lack health insurance of any kind.

But their health is due to change for the better after Tuesday.

That's when Maryland's landmark expansion of Medicaid goes into effect. Eventually, more than 100,000 uninsured people will qualify for some type of health care under the legislation passed by the General Assembly last year.

The Hohmans' 13-year-old son already receives help from the federally supported medical assistance program, but now his parents will be able to enroll, too. Maryland's Medicaid program has long been geared toward helping children in poverty, but this has also been one of the stingiest states in the nation when it comes to providing care for their parents.

Even with the change, it's still far from a bonanza. Eligibility standards for poor adults will now rank somewhere around 21st in the nation, health care advocates say, but it's a distinct improvement from Maryland's former position in the bottom five. The new law also provides premium subsidies and other benefits to small employers who haven't been able to provide health insurance to their workers.

Obviously, this is no cure-all for the many woes of the health care system. Medicaid has become a huge expense, and other avenues, such as requiring private health insurance for those who can afford it, will also have to be pursued.

But for the working poor like the Hohmans, this is a godsend. And when critics of Gov. Martin O'Malley and the legislature grouse about expanding government, they ought to be reminded of the reasonable health care benefits our most vulnerable families are getting in return.