Health Care for All! Plan Specifics
The first section of this proposal describes reforms to the financing and organization of health insurance coverage in the state, including a mandate that all residents obtain coverage. We propose to:
- Create the “Maryland Health Insurance Pool” to make insurance affordable by both merging the individual and small group markets and providing premium subsidies for lower-income residents;
- Provide a “Catastrophic Reinsurance” benefit that covers at least 75% of high annual health spending over $35,000 for all currently uninsured and privately insured residents; and
- Expand Medicaid eligibility for non-parents up to 200% of the federal poverty line and parents up to 300% of poverty in a better coordinated “Healthy Maryland” program.
- Create the “Maryland Institute for Clinical Value” which will implement a “value based” insurance design that emphasizes the provision of care with well-established cost-effectiveness;
- Support projects, in large part based on electronic health records, that will improve the coordination and effectiveness of care for persons with chronic conditions; and
- Emphasize culturally appropriate prevention and health promotion to improve overall public health and reduce health disparities.
- Total costs to the state of about $15.5 billion over five years from FY 2010 to FY2014, comprised of about $4.3 billion for low-income subsidies and other costs in the Maryland Health Insurance Pool, about $7.6 billion for the Catastrophic Reinsurance program, about $3.1 billion for the Healthy Maryland Medicaid expansion, $166.0 million for the Maryland Institute for Clinical Value, and $407.5 million for prevention and promotion activities; and
- Total revenues of about $15.5 billion over five years, comprised of about $13.2 billion from a 2.0% employer payroll tax on wages under the FICA cap, about $1.0 billion from an increase in the alcohol tax, $516.4 million from increased taxes on cigarettes and other tobacco products, $150 million from the tobacco settlement bonus payments, and $590.7 million re-allocated from the state high risk pool.
The second section describes reforms to the delivery of health care in the state of Maryland meant to improve quality and cost efficiency. We propose to:
- The third section describes the financing of this proposal. We propose new revenue sources to fund all additional spending so that there is no use of the state’s general funds. We estimate that the plan would have: