O'Malley Turns to Health Care

Mayor Says State Must Do More to Cut Costs of Coverage

Gubernatorial candidate Martin O'Malley, right, and his running mate, Del. Anthony G. Brown (D-Prince George's), center, discuss a new health care plan with small-business owners in Ellicott City. (By Marvin Joseph -- The Washington Post)

Baltimore Mayor Martin O'Malley promised yesterday that, if elected governor, he would aggressively pursue ways to make health insurance and prescription drugs more affordable, the latest in a series of campaign pledges targeting middle-class angst.

Appearing in Ellicott City, the Democratic hopeful embraced ideas such as helping Marylanders buy drug refills from Canada, sponsoring an insurance purchasing pool for small businesses and providing tax credits to entice companies to participate.

Although he offered no "silver bullet," O'Malley said Maryland must join other states in doing more to make health care affordable, given a lack of comprehensive federal reform and what he described as scant attention from the incumbent, Robert L. Ehrlich Jr. (R).

"We have two choices in the face of this complex problem," O'Malley said. "We can continue to do nothing . . . or we can roll up our sleeves and try to find solutions."

Ehrlich later brushed off O'Malley's criticism and said he has been committed to making health care more affordable since his days in Congress. The governor also questioned whether O'Malley's plan to allow drug purchases from abroad was legal. And a campaign aide asked where O'Malley would find the money. "It's easy to roll out a sketchy position paper," said Ehrlich spokeswoman Sharese DeLeaver. "The difficult part is the financing."

She said that during Ehrlich's tenure, an additional 80,000 Marylanders had gained access to health care, mostly through the Medicaid program, because of the governor's spending commitments.

The O'Malley campaign fired back with another statistic: census numbers suggesting that the number of uninsured residents in Maryland grew by 160,000 during Ehrlich's first three years in office.

O'Malley is devoting two weeks to highlighting his proposals on health care, which could be important this year given voters' other pocketbook concerns, such as rising gas prices and utility bills.

A statewide poll conducted this year found that 71 percent of voters said "a lack of affordable health insurance coverage" was either an "extremely serious" or a "very serious" problem in Maryland. That was second only to "crime, drugs and gangs," cited by 76 percent of voters in the poll by Fairbank, Maslin, Maullin & Associates.

"Concern about health care is quite significant," said Steve Raabe, president of the Annapolis-based OpinionWorks. "It's definitely a potent issue if properly discussed."

O'Malley sought to put a human face on the topic by holding a discussion before his announcement with small-business owners such as A. Nayab Siddiqui, president of an information services company in Columbia with 43 employees.

"It's killing us," Siddiqui said of his company's health-care costs. "Can we sustain this forever? I don't think so."

O'Malley's focus on health care won praise yesterday from the Maryland Citizens' Health Initiative, a leading proponent of expanded access. The group has been enlisting candidates to support its top legislative priority: a $1 increase in the state cigarette tax that would be used to pay for an array of health initiatives, including expansion of Medicaid, the state and federal insurance program for the poor.

Two Democratic candidates for comptroller -- Del. Peter Franchot (Montgomery) and Anne Arundel County Executive Janet S. Owens -- became the latest politicians to announce their support yesterday for the group's plan. Montgomery County Executive Douglas M. Duncan had endorsed the plan before he dropped out of the Democratic primary race for governor last month.

Vincent DeMarco, the group's president, said he remained hopeful that O'Malley would back the plan, but O'Malley suggested yesterday that is unlikely. Aides have said it is politically risky to support a tax increase, even on tobacco, during an election year.

O'Malley released limited information about how he would pay for his proposals. One exception was a state reinsurance fund that would cover high-risk participants in a small-business purchasing pool. O'Malley said the fund could be started with $30 million from an existing state insurance program.

O'Malley said Maryland should not hesitate to duplicate programs in other states, such as an Illinois initiative launched without federal permission that allows residents to purchase cheaper drug refills from licensed pharmacies outside the United States. Many jurisdictions, including Montgomery, have sought -- and been denied -- federal permission for similar initiatives.

Hari Sevugan, an O'Malley spokesman, said the mayor was willing to stand up to the Bush administration on the issue, although Ehrlich clearly is not.

O'Malley also suggested duplicating a Maine program that lowers drug costs through bulk state purchases and creating a statewide drug discount card. Similar cards are available in Montgomery and Baltimore.