ANNAPOLIS, Md. (AP) - Several Maryland health groups expressed support Wednesday for a measure that would bring back the individual mandate for health insurance in the state, with what supporters are calling an innovative twist: give the uninsured a choice of either paying a penalty at tax time or making a down payment toward a health insurance plan.
Supporters say it’s a creative way of trying to protect the federal Affordable Care Act in Maryland by reinstating the mandate that the federal government won’t be enforcing in future years, after a change made in the 2017 federal tax overhaul.
“We’re incentivizing people to use their own money to purchase health insurance for them and their family, and that’s important, because among other things we particularly want to incentivize young healthy people to be part of the insurance pool - because when they’re not in the insurance pool, we’re insuring an older, sicker population, which drives premiums up for everybody else,” said Sen. Brian Feldman, a Democrat who is sponsoring the legislation, along with Del. Joseline Pena-Melnyk.
Stan Dorn, who is director of the National Center for Coverage Innovation, estimated there are tens of thousands of Maryland residents who do not have health insurance who are actually eligible for low-cost insurance but don’t know it. He estimated there are about 50,000 Medicaid-eligible uninsured who could be reached when they file tax returns. Dorn also estimated the state has 70,000 uninsured who have access to federal premium tax credits and another 10,000 residents whose required down payment under the bill would pay for most, if not all, of their premiums.
“So essentially 130,000 uninsured Marylanders right now have access to zero-cost insurance and they have no idea, and even if they do it’s complicated to sign up,” Dorn, who also is a senior fellow at Families USA, a health care consumer organization, said.
The measure stalled last year in Maryland, but supporters are hoping the idea is gaining momentum. Representatives from the Maryland Hospital Association, the American Heart Association, 1199 SEIU and the Maryland State Medical Society spoke in favor of the measure at a news conference in Annapolis.
“Our physicians see quite regularly, especially in the emergency rooms, people who come in with illnesses and ailments that could have been prevented if only they had access - and if they had known they had access - to things like Medicaid or low-cost health insurance, so we just want people to know that there are options out there for them, that they can afford it,” said Teresa Healey-Conway, the executive director for the Anne Arundel, Howard and Prince George’s county medical societies.
Opponents say the measure amounts to penalizing people for being poor.
Sen. Michael Hough said he recently attended a hearing where he heard about farmers who want insurance, but simply can’t afford it. The Republican described the measure as “a tax on the poor,” no matter how supporters describe it.
“We don’t go to homeless people and charge them a penalty and say, ‘we’re going to make a home for you,’” Hough said.
Massachusetts has had an individual mandate since 2006. New Jersey and Vermont have implemented individual mandate requirements, but they rely on a straight-enforcement approach: people are penalized for being uninsured, Dorn said. Maryland would be the first to try the down-payment approach, Dorn said.
“We want to see it passed in Maryland, and then we’re going to start beating the drum and going all around the country and encouraging people elsewhere to take a look at it,” Dorn said.
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