Md. House Votes to Expand Health Coverage
By Lori Montgomery
Washington Post Staff Writer
Saturday, April 3, 2004; Page B04
The Maryland House of Delegates voted yesterday to expand health care coverage for the uninsured, approving a $154 million plan to enlarge the state's network of community health centers and to increase Medicaid eligibility for poor adults for only the second time since the 1960s.
On a vote of 86 to 54, the House gave final approval to a complex health care package and agreed to fund it by imposing a 1 percent tax on HMO premiums. Under the proposal, the state would use money from a national settlement with tobacco companies to increase payments to doctors who treat Medicaid patients, and it would seek additional funds from the federal government.
The plan's author, Del. John A. Hurson (D-Montgomery), said the package would extend some Medicaid coverage to 75,000 uninsured parents who earn less than 200 percent of the federal poverty level, or about $30,500 for a family of three. Their children are already covered through another state program. But the parents are eligible for Medicaid only if they earn less than 45 percent of the poverty level, or less than $7,000 for a family of three.
Hurson, who chairs the House Government Operations Committee, said the plan would expand access to free or low-cost primary care for an additional 200,000 uninsured Marylanders who earn less than 300 percent of the federal poverty level, or about $45,750 for a family of three.
The plan represents a first step on the path toward universal health care, a goal endorsed last fall by the Democratic leaders of the House and Senate and by Republican Gov. Robert L. Ehrlich Jr. About 700,000 Marylanders lack health insurance.
Ehrlich last year vetoed a bill to tax HMO premiums, and top aides said this week that the governor remains opposed to such taxes. In an interview, Ehrlich said his budget and health secretaries are working with Hurson to find another funding source, and have offered to add $15 million to the state budget for the program.
"The policy in the bill is policy I've advocated for years," Ehrlich said. "We're hopeful we can break that logjam."
But with only 10 days left before the General Assembly is scheduled to adjourn, Hurson said Ehrlich's offer is too little, too late. He called on the governor to take note that his bill won enough votes to override a gubernatorial veto.
"At some point, if you really want to do something about the health care problem, you have to do something to raise revenues," Hurson said. "Maybe the veto-proof vote in the House will move them."
Hurson has other forms of leverage: His committee has yet to act on several important pieces of the governor's legislative agenda, including measures to reform state contracting rules to benefit minority businesses and to create a Cabinet-level Department of Disability Services. Earlier this week, Hurson said he would advance the governor's agenda "when we see a little more cooperation on this health care bill."
The health care package now moves to the Senate, where leaders are working on their own version.
The Senate's bill is likely to include a 2 percent tax on HMO premiums rather than tapping the tobacco settlement fund, which is dedicated primarily to cancer screening and smoking cessation programs, said Finance Committee Chairman Thomas M. Middleton (D-Charles).
Hurson and Middleton expressed frustration with Ehrlich's opposition to the HMO tax, saying it would simply eliminate an exemption created years ago to help HMOs become established in the insurance market. Other forms of health insurance are taxed already.
Middleton noted that the Senate has taken other steps to expand coverage for the uninsured that do not require new revenue. They include a measure, endorsed in concept by Ehrlich, that would create a less-expensive, bare-bones health insurance policy attractive to small employers who cannot afford to offer their workers insurance.
The Senate unanimously approved that bill, sponsored by Sen. Leonard H. Teitelbaum (D-Montgomery), and sent it last week to the House.
Republicans contend that taxing HMO premiums would increase the skyrocketing cost of health insurance. Ehrlich's health secretary, Nelson Sabatini, has said universal access to health care should be achieved instead through a system of tax penalties and credits.
© 2004 The Washington Post Company