Maryland gubernatorial candidate Ben Jealous (D) told a gathering of progressive activists in Western Maryland this week that he plans to push for a state-run, single-payer health-care system if he wins the governorship — assuming the federal government doesn't already have such a program in place.
“We have to make sure every Marylander who currently lacks health care gets it,” Jealous said. “I’m committed to getting single-payer.”
A single-payer system, in which the government directly pays for every American’s health care, would likely be modeled after similar programs in European countries. The Republican attempts to rescind Obamacare have rekindled calls for such a system among left-leaning U.S. politicians. Califronia and New York have recenty weighed bills to create single-payer systems in their states.
Jealous, who explained his stance on the issue Monday to an audience in Garrett County, said he is working with economists and legislative experts to develop a detailed proposal for Maryland, for release later this year.
On Friday, two of his rivals for the party’s 2018 nomination also advocated for expanding the state’s role in providing health care.
State Sen. Richard Madaleno (D-Montgomery) said "the immediate way forward" if Congress and President Trump repeal the Affordable Care Act is to establish a state-run public option, while Maryland's elected leaders debate moving to a single-payer system that covers everyone.
Fellow candidate Alec Ross, a Baltimore tech entrepreneur, said "Maryland needs a governor who will commit to a state-run public option."
A public option would mean the state setting up a health program to compete with private insurance, whereas single-payer programs involve the government providing health coverage for everyone.
“I like the idea of single-payer, but people will need options right away,” Madaleno said. “The public option would help people who need it quickly and affordably.”
By declaring support for a possible drastic expansion of the state’s role in providing health care, Jealous, Madaleno and Ross are staking out far-left positions that could appeal to staunch progressives but alienate them from centrist Democrats as they compete in a crowded primary.
The Republican-controlled Congress is trying to move in the opposite direction, with proposals that would gradually reduce federal support for Medicaid and make insurance more expensive for older adults and people who buy individual plans.
“We can do better and we must do better, and the way to do that is to create the equivalent of Medicare-for-all at the state level,” Jealous said. “If the federal government won’t do it, our state governments must do it.”
Gov. Larry Hogan (R) did not immediately respond to a request for comment on whether he would embrace a single-payer system for Maryland. But he has criticized Congress’s latest plan for replacing the Affordable Care Act.
“We know the current system needs to be fixed but the proposals that are being considered in Congress do not work for Maryland,” Hogan spokeswoman Amelia Chasse said Thursday. “Congress should go back to the drawing board in an open, transparent and bipartisan fashion to craft a bill that works for all Americans.”
Prince George's County Executive Rushern L. Baker III and Baltimore lawyer James Shea have joined Jealous, Madaleno and Ross in saying they will compete in the June, 2018, primary. At least three others are weighing bids, including U.S. Rep. John Delaney; Baltimore County Executive Kevin B. Kamenetz; and former Maryland attorney general Douglas F. Gansler.
Shea took a centrist position on the health-care issue, saying Friday that “Maryland’s next governor is going to have to bring together the state’s doctors, hospitals and insurers to further adapt our state’s health-care system to ensure we sustain access to affordable high quality health care for everyone in our state.”
Lawmakers in California and New York are considering bills to adopt single-payer health systems for their states, but support for the plans has been sporadic amid concerns about costs. In both legislatures, the measures appeared to stall after passing out of one chamber, and neither of the state’s governors have indicated what they would do if the proposals reached their desks.
Attempts to establish single-payer health programs through legislation or ballot measures have failed in at least nine other states.
In 2011, Vermont passed the nation’s first, and so far only, law to establish a state-run single-payer health system. Then-governor Peter Shumlin (D), who signed the legislation, abandoned the plan in 2014, saying it “might hurt our economy.” The program would have required an additional 11.5 percent payroll tax on businesses and a tax hike of up to 9.5 percent on personal income.
Advocates for universal health care say the Vermont plan did not truly involve a single-payer system because it would have exempted large businesses that operate across state lines.
Madaleno, who is vice chair of the state Senate’s Budget and Taxation Committee, said a government-administered health program for Maryland would have lower premiums than private insurance because of lower overhead and no profit-taking. “It should have minimal impact on the state budget,” he said.