The push is on in Maryland to have a universal health care road map ready to use when the Obama Administration and Capitol Hill finalize the direction of their expansive health care reform.

In March, the chairmen of the two committees of the Maryland General Assembly that debate health insurance legislation co-sponsored Senate Bill 515 and its companion bill, House Bill 860. The legislation would create the “Healthy Maryland Plan,” a new comprehensive insurance offering for the individual market with sliding-scale subsidies for low-income individuals.

The bill would offer coverage to every Maryland resident regardless of health status or pre-existing conditions, with mandates for both individuals and employers.

Thomas "Mac" Middleton

“This is a very, very important piece of legislation or I would not have put my name on it,” Sen. Thomas M. “Mac” Middleton (D-Charles County), told IFAwebnews.com. “I think this is a reasonable approach to provide more health care coverage to Marylanders.”

Middleton, the chairman of the Senate Finance Committee, and Del. Peter A. Hammen (D-Baltimore City), chairman of the House Health and Government Operations Committee, worked on the bill with Owings Mills, Md.-based CareFirst. The bill is now in the summer study process where various stakeholders meet to make it ready to present to the General Assembly in January 2010.

Aligning efforts

Middleton said everyone involved is cognizant of what is going on with health reform on Capitol Hill, with the goal of making sure the work done in Maryland parallels that of the federal government.

“There is a sense of urgency [here],” he said. “If Congress says they want something in November …we have to be sure we don’t lag behind on our plan, so we can be ready to move.”

Middleton said the hope is that the federal government lets states develop their own plans with several guidelines to follow to ensure health care for all can become a reality.

“Now is the time…if we can develop a plan for uninsured Marylanders that is affordable to them and push personal responsibility,” he said.

Reaching consensus

Middleton said the goal for this summer is to make sure all the stakeholders in Maryland’s health care industry are identified and work toward a consensus.

“You can rest assured that all the parties will have a place at the table,” he said.

Bill Casey, vice president of government affairs for CareFirst, discussed the bill’s origins with attendees of the Maryland State Expo, co-sponsored by the Maryland Association of Health Underwriters and NAIFA-Maryland.

With an estimated 780,000 uninsured Marylanders attributing for billions in direct and indirect costs to the health care system and funding for new initiatives at the state level non-existent, Casey said the task was a large one.

“The bill had to substantially decrease the uninsured population and couldn’t raise taxes and that’s a pretty big challenge,” he said. The estimated cost of the initiative would be $1.6 million, with $1.2 million paid through enrollee premiums.

Plan’s elements up for debate

Deborah R. Rivkin

Acknowledging that elements like an individual mandate have support, Casey said other elements, including the “most controversial” employer mandate stipulation, are not as popular with stakeholders.

Deborah R. Rivkin, executive director and lobbyist for the League of Life and Health Insurers of Maryland, called the employer mandate “a mistake.”

“Not all employers can afford it, but some can contribute to their employees’ health insurance on a pre-tax basis, letting employees purchase the plan of their choice,” she said. “We support that.”

As for the single product/single price idea, Rivkin said “more products promotes innovations coming into the marketplace and we shouldn’t stifle that in Maryland.”

Key Elements of ‘Healthy Maryland’
Health insurer CareFirst has identified 10 key elements of the proposed universal health plan:
*An individual mandate for those under 65 and above 300% of the federal poverty level
*One community-rated pool to avoid adverse selection
*All carriers must offer the same Healthy Maryland product
*Guaranteed issue / no medical underwriting
*Promotion of healthy behaviors
*A mandate for employers; penalty for non-compliance
*Subsidized premiums for low-income individuals
*Self-sustaining, dedicated funding source
*An established rate-setting process by MIA
*All residents under 65 must obtain “creditable” coverage; at least equal to benefits under plan
Source: CareFirst

This story originally appeared in the July 2009 print edition of Insurance & Financial Advisor.