Health issues high on agenda

GLEN BURNIE, Md. — Retiree Lydia Sanders is not happy with her health care. At 65, she is on Medicare, but still has to pay for some medications and treatments.

“You can’t afford good health insurance unless you have a really good job,” Mrs. Sanders said. “I still have to pay so much out of my pocket. When people have a serious illness, or their children, they have to have a flea market or a yard sale to pay for it. It’s ridiculous.”

Frustration with health care — including the growing number of Marylanders who cannot afford coverage — is getting attention from state lawmakers. Dozens of health-related measures could be considered at this year’s General Assembly session, from minor tweaks to sweeping plans to boost the number of people covered by health insurance.

Maryland has 750,000 to 800,000 residents with no health insurance, which is 14 percent of the population, according to state estimates.

Without insurance, many people avoid routine but expensive medical work and seek doctors only when they are seriously sick. That means bigger bills for the insured, who shoulder the cost of emergency care for the poor through higher premiums.

Several plans in the state legislature would address the problem by putting more people on Medicaid, which helps pay for health care for the poor and disabled. Adults in Maryland are eligible if they make less than 39 percent of the federal poverty level. A single adult making $4,000 a year cannot qualify. Some lawmakers think the first step is to change the Medicaid benchmark to at least 100 percent of federal poverty guidelines, or $10,210 a year for a single adult.

The current Medicaid guidelines are a major reason the uninsured problem is growing in Maryland, said Delegate Peter A. Hammen, a Baltimore Democrat and a chief backer of a health care reform plan.

“Four years ago, we had 600,000 uninsured,” he said. “Today, we have nearly 800,000. The more we delay, the more uninsured we will have.”

The state will spend about $4.7 billion this year on Medicaid. Adding more people could increase Medicaid costs at a time when state government doesn’t have money to spare. A budget deficit of roughly $5 billion over the next several years has been projected, unless the Democrat-controlled legislature decreases spending or finds other revenue sources such as tax increases.

The lawmakers passed legislation last year to force Wal-Mart Stores Inc. to improve health care benefits for its workers, in part to reduce Medicaid rolls.

They enacted the law over a veto by Gov. Robert L. Ehrlich Jr., a Republican. Two federal courts have since ruled the law is illegal.

Mr. Hammen wants a $1-a-pack cigarette tax increase to raise Medicaid eligibility to 116 percent of the federal poverty level.

Gov. Martin O’Malley, a Democrat who took office last month and has said he doesn’t want new taxes this year, has proposed small changes in health insurance. His legislative agenda includes a new rule requiring health insurers to cover adult dependents up to age 25, which could reduce the number of young adults who don’t have health insurance.

Mr. O’Malley also has suggested a task force to study whether Medicaid should be expanded. He also proposed an insurance exchange to help small businesses afford to offer insurance.

A statewide poll of 809 registered voters showed one in five named “health care costs/access” as the most important issue facing Maryland. The telephone survey had a margin of error of 3.5 percentage points.

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