Maryland proposal uses individual, employer mandates to ensure health care coverage

Maryland lawmakers and CareFirst BlueCross BlueShield on March 4 offered a Massachusetts-style solution to covering most of the state's roughly 800,000 uninsured residents.

The proposal -- Healthy Maryland -- would require individuals to obtain health insurance and employers to maintain or offer coverage. Employers who fail to do so would face penalties, as would people earning 300% or more of the federal poverty level who fail to comply.

The $1.6 billion plan also would transform the state's individual health insurance market by creating a health insurance exchange with subsidized coverage for people at less than 300% of the poverty level. Plans could not exclude applicants based on preexisting conditions or health status. The coverage would provide primary and preventive health services with an emphasis on promoting healthy behaviors.

Some $1.2 billion of Healthy Maryland's funding would come from premiums. The rest would come from the state's uncompensated care fund for hospitals, penalties from the employer and individual mandates, and other sources.

But Healthy Maryland is not expected to be adopted this year, according to CareFirst spokesman Michael Sullivan. Instead, lawmakers will study it over the summer and consider it seriously in 2010. "The notion was to get a thoughtful proposal on the table to get a very real starting point," he said.

MedChi, Maryland's state medical society, hasn't adopted a position on Healthy Maryland, said Executive Director Gene Ransom. "We appreciate the importance of it and we want to be part of the conversation."

MedChi is more focused on supporting bills recommended by Maryland Gov. Martin O'Malley's Task Force on Health Care Access and Reimbursement. These bills would increase physician payment by adjusting the state formula for health plan rates for physicians who do not participate in the plans. "Those issues are ripe. They're ready for action," Ransom said.

More information about Healthy Maryland can be found online (link).