Maryland Considering Mandatory Health Insurance

The Maryland Health Care Commission is beginning work on a plan that could be presented to the legislature as early as January that would require all Marylanders to buy health insurance.

The draft proposal would create an insurance exchange offering a variety of plans to individuals who would choose the coverage they want and be able to keep that coverage if they change jobs. Employers would pay much of the cost, and the state would subsidize costs for low-income workers.

For many Marylanders, the plan would be a radical change from the current system, in which employers choose health insurance plans. Big companies would be excluded from the plan, although no decisions have been made yet as to what the cutoff point would be.

A draft of a plan was presented lasy Thursday by the staff of the Maryland Health Care Commission. “This is not a proposal,” Stephen J. Saloman, the commission chairman, said. “It is a work in progress.”

Saloman said the commission will discuss the proposal with legislative leaders and Gov.-elect Martin O’Malley as more details are developed.

Massachusetts is the only state that has passed a law mandating that virtually all citizens have health insurance, but the law hasn’t taken effect yet.

No decisions have been made on key details of the Maryland plan, including the cost of subsidies, who could purchase coverage from the insurance pool, the penalty to be paid by people without insurance and how premiums would be established.

The commission staff is waiting for results of studies by consultants, and hopes to have more details for the commission by next month.

Health care is expected to be a major issue in the 2007 General Assembly session. An estimated 750,000 Marylanders have no insurance, and many of those wind up getting expensive treatment in hospital emergency rooms when they get sick.

O’Malley said during the gubernatorial campaign that he would look for ways to lower premiums and expand the state’s current insurance plans for small employers. House Speaker Michael Busch puts health care among his top priorities.

A $1 per pack increase in the state cigarette tax is being pushed by the Maryland Citizens Health Initiative to raise an estimated $200 million a year to expand Medicaid to more adults and to subsidize small businesses that can’t afford to pay for health insurance for their employees. The Maryland Hospital Association considers expanded health insurance coverage its top priority.

“If you look at the politics of the new administration and legislature, it’s more feasible to get all the parties together,” Calvin Pierson, president of the hospital association, said.

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