Baltimore Sun
June 26, 2017
Carmela Coyle and Hank Greenberg

The U.S. Senate’s health care bill, set to be voted on this week, carries worrisome ramifications for every one of us in Maryland — not just for those who will lose their health care coverage.

Health care reform under the Affordable Care Act meant an additional 450,000 Marylanders over the past five years gained access to affordable, quality health care at the right time, in the right setting: doctor’s offices, hospitals, pharmacies, nursing homes and more. But that progress, the well-being of hundreds of thousands of Marylanders and the cost of health care for each of us is in jeopardy.

The Senate bill would make Maryland’s health care system less secure and less affordable. That is why our organizations are so deeply concerned. The fact is every one of Maryland’s 6 million residents would be dramatically affected by the cuts to coverage currently being considered.


If passed, the bill may result in hundreds of thousands of Marylanders losing health care coverage. Some will choose not to have insurance because they don’t think they’ll need it. Others will have no choice at all — they simply won’t be able to afford health insurance as the current subsidies to make coverage more affordable would be reduced. Further, the bill would force 146,000 Marylanders aged 50 to 64 to pay thousands of dollars more than other people. And it would devastate Medicaid, stripping coverage from tens of thousands. It would leave countless seniors at risk of not getting the care they need.

The legislation also allows states to remove critical protections for people with serious health conditions, like heart disease, drug addiction, diabetes and asthma.

The bottom line is that the costs of the proposal — in both dollars and lives — would simply be too great to bear. Without health insurance or Medicaid, thousands upon thousands of Marylanders will have to cope with their health care needs on their own, including those suffering with drug addiction and mental health challenges. It will be expensive, if not impossible, for many to see their doctors on a regular basis and get the routine care they need. Thousands will not be able to pay for the medicines they need to keep chronic conditions like diabetes or high blood pressure under control. They won’t be able to secure the home health aide they need to continue living independently at home instead of requiring hospitalization.

Ultimately, people will forgo care, until their health conditions are so acute that they need hospitalization. And for many, the hospital emergency department will again become their only source of routine, and very expensive, care.

As Marylanders lose their health coverage, the cost of care they receive, but can’t pay for, gets passed on to everyone else in the form of higher health care costs and higher insurance premiums.

The cost of caring for people in the hospital who had no insurance or could not afford their care dropped by $350 million as a result of the coverage they gained under the Affordable Care Act, whereas this Senate bill would drive up the cost of health care for everyone in Maryland.

And every Marylander would pay for the proposed dramatic shift in how Medicaid is funded, as the burden of paying for health care is pushed back on to states. The Senate bill is expected to cut federal Medicaid funding for Maryland by millions of dollars in 2018 alone and billions over the next decade. That leaves our state, and many other states, with an enormous budget hole. The choices are grim: raise taxes, cut state health care spending, cut state spending for other activities or care for even fewer Medicaid enrollees. Any one of these choices affects every Marylander.

AARP Maryland and Maryland’s hospitals see firsthand every day the difference that greater health care coverage has in the lives of those we serve. We have seen how getting people the care they need when they need it has made health care overall more affordable and has made people’s lives better. And we see the tremendous potential that lies ahead if these improvements can continue.

However, the Senate bill takes us in the opposite direction. We urge Congress to protect patients and preserve coverage so Marylanders get the care they need and deserve.

Carmela Coyle ( is president and CEO of the Maryland Hospital Association; Hank Greenberg ( is Maryland state director of AARP.

Last modified: June 28, 2017