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State health care expansion needs fed funds
Wednesday, Nov. 18, 2009
 Click here to enlarge this photo Staff photo by GRETCHEN PHILLIPS
Vincent DeMarco, right, president of Maryland Citizens Health Initiative, shakes hands with Sen. Thomas "Mac" Middleton in front of the Charles County Family Center where officials celebrated the many Marylanders who have benefited from health care expansion. Pictured at center is Charles County commissioners' Vice President Edith J. Patterson and Commissioner Samuel N. Graves Jr. is at far left.
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As Congress weighs a massive overhaul of the nation's health care system, state and local officials gathered in La Plata on Monday to tout Maryland's efforts in extending coverage to the uninsured.
Advocates hope to add to the more than 1,100 Charles County residents who are newly covered under the 2007 state health care expansion, even as a key state legislator recently cautioned that might not be possible without federal funding.
"These are very tough times, and it's a tough time for the budget," said Sen. Thomas "Mac" Middleton during a news conference held outside the Charles County Family Center. "More and more people are standing up … and enrolling in the health care expansion. Hopefully when the economy expands, we can [too]."
But Middleton (D-Charles), who chairs the Senate Finance Committee, which oversees state health policy, signaled at a Maryland Chamber of Commerce conference earlier this month that the state needs federal assistance to reach the program's goal of covering 100,000 Marylanders.
"We'll probably have to look at whether or not we can afford what we just expanded," he said after participating in a panel discussion on federal health care reform at the conference in Cambridge.
The state health care expansion, passed during the 2007 special legislative session, increased the Medicaid eligibility threshold from 40 percent of the federal poverty level to 116 percent of the poverty level. At the time, about 800,000 Marylanders lacked health insurance and proponents maintained that expanding coverage would decrease emergency room visits and reduce premiums, while opponents decried the high price tag. It was primarily funded by a $1-per-pack cigarette tax increase.
"We all benefit when health care is expanded," said Vincent DeMarco, president of the Maryland Citizens' Health Initiative. "One thousand dollars of everyone's insurance premiums goes to cover hospitalization and care for the uninsured. It's the hidden health care tax. By expanding the health care program it's good for the uninsured and it's good for all of us."
As a result, Maryland now ranks 16th among states in Medicaid eligibility for low-income adults, DeMarco said, citing data collected from the Kaiser Family Foundation this April. Two years ago, Maryland ranked 44th, he said.
Now is not the time for the state to abandon its commitment to covering more uninsured residents, expansion supporters said.
"At this recession time, we can't bury our heads in the sand," said Charles County Commissioner Samuel N. Graves Jr. (D). "If we keep our citizens healthy, they can go to work. If we don't take care of our citizens, we end up with more costly emergency room situations."
But the economic realities are grim.
Middleton said the expansion has cost tens of millions of dollars more than originally anticipated and with Gov. Martin O'Malley (D) proposing his third round of budget cuts in the last five months, there might not be money available for health care unless the federal government steps in with a temporary cash infusion.
Given the cuts already passed down to local governments earlier this summer, Charles County Health Officer Chinnadurai Devadason lauded the commissioners' efforts to avoid cutting his department, which in turn has allowed providers to do their job.
"Health care for all, that's what it's all about," Devadason said. "We've been able to sustain much of what we've been doing but it's not been easy. It's been an accomplishment that's the first small step for health care for all."
State cuts led officials in St. Mary's County to lay off 12 health department employees.
"Part of my enthusiasm today is because we see ourselves as partners," said commissioners' Vice President Edith J. Patterson (D). "We're making every effort to make citizens aware of the program."
Despite his warnings, Middleton hopes Congress will provide an additional six months of funding to states for Medicaid that would ensure money is available through 2012.
"It would be a better bridge for when the economy improves," he said.
For more information on how to enroll, call 211.
Staff writer Sean R. Sedam contributed to this report.
