February 18, 2011

GOP delegates want to throttle Maryland’s speedy implementation of health reform

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By Len Lazarick
Len@MarylandReporter.com

Del. Nic Kipke holds up a chart of the agencies implementing health care reform.

Republican members of the House of Delegates want to slow down Maryland’s rapid implementation of federal health reform, calling it a potential waste of money now that two federal judges have overturned some or all of the law.

“We need to take a deep breath in the state of Maryland,” House Minority Leader Tony O’Donnell said at a news conference with most of his 43-member caucus.

“We have till 2014 to implement this.”

Governors and attorneys general in Virginia, Florida and other states have filed lawsuits against what the GOP calls “Obamacare.” But the O’Malley administration has embraced the Affordable Care Act since it was enacted last March, and this year has introduced a package of bills to help Maryland comply with its provisions.

One of the key provisions of the O’Malley administration’s plan is the health benefit exchange, which is designed to help 750,000 uninsured residents get health insurance and provide subsidies to low-income people so they can afford it. The exchange is also designed to help businesses shop for the best and most affordable health insurance plans.

Like representatives of doctors and business groups who testified on the administration bills earlier this week, the Republicans oppose O’Malley plans to create a new government agency to run the exchange, with a board that includes three cabinet secretaries. The Republicans also complained that they had no representation on the coordinating council that developed the plans last year.

Instead, the business groups and the GOP want to set up a nonprofit corporation that also must have open meetings and transparent financial dealings as would a government agency. They also want to protect the role of the private insurance brokers that employ over 20,000 people and provide the health insurance coverage for most of the small employers in the state.

“The most important sector to get input from … is the private sector,” said Del. Wade Kach, R-Baltimore County.

“The only worse thing than dealing with insurance companies is dealing with government agencies,” O’Donnell said.

Lt. Gov. Anthony Brown, the administration’s lead spokesman on health care reform, has promised the brokers that they will have a seat at the table in shaping the exchange. But they fear that some small businesses the exchange website will compete with them in offering health coverage.

Brown’s press secretary Mike Raia attended the Republican news conference.

“What I was hearing was a partisan commitment to weaken the efforts that have been made to provide affordable health care” to more Marylanders, Raia said.

“Waiting would set us back and put us behind the curve,” Raia said, undermining the administration’s effort to be “a national model” for implementation of the president’s plan. “It’s irresponsible.”

Health Care for All President Vincent DeMarco, the most prominent advocate for expanding health insurance coverage, said, “Maryland should go forward the way the governor has proposed. It’s a smart way for Maryland to take advantage of the health care act.”

States that don’t start implementing the new law are doing their citizens “a disservice,” DeMarco said. If Maryland delays setting up the new program, “we’re really behind the 8-ball and won’t be ready for 2014. There’s just a lot to do.”

Last Friday, all 43 Republican delegates introduced a state constitutional amendment that would prohibit the state from requiring anyone to buy health insurance coverage, the provision of the federal act that has been struck down by judges in Virginia and Florida.

Two other federal district judges have upheld the national law.

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  • Leni

    Those who suggest that we have until 2014 to pass legislation implementing the federal law – the Affordable Care Act – are either short-sighted or uninformed. Fortunately, Maryland’s leadership is neither. They understand that to meet the requirements of the ACA and to be eligible for necessary federal funds, the legislature must pass, and the Governor sign, a bill establishing the structure of the Health Insurance Exchange. The legislation now being debated is substantive. However, the Maryland Women’s Coalition for Health Care Reform and others concerned with the importance of the Exchange meeting the needs of all Marylanders, feel it can be improved. We have proposed amendments to that effect and are most appreciative of the efforts of the Lt. Governor and the legislators who are working with us.

  • Jturne

    Certainly, in the event efforts to have the “Affordable Care Act” ruled unconstitutional by the Courts an its provisions can not be severed are successful, the Act repealed, and/or its provisions defunded should succeed – this State’s Administration could press ahead to implement a Massachusetts style State program (a substantially destructive effort). However, considering our State’s current precarious fiscal status (as described in the excerpts below) it seems to me that a rapid implementation of ObamaCare in pursuit of a Sebelius, Berwick, Emanual, Obama gratitude is not in the interest of Maryland Citizens and tax payers. I am very grateful we have responsible, adult, elected officials suggesting that the State wait for an opinion as to effect of Judge Vinson’s ruling and if it is, whether a temporary stay will be granted. Numerous articles have been written exposing the exploding costs and taxations attendant the Affordable Care Act and the withering impact on the extent and quality of care citizens will receive. Mr. DeMarco’s enthusiasm not withstanding, I remain hopeful a responsible sanity will ultimately prevail and that more appropriate solutions to medical insurance costs and coverage will ultimately be developed.

    US District Court Judge Roger Vinson in Florida, considering a challenge to the health care overhaul by a group of 26 states, ruled Jan. 31 that the entire law must be declared void.

    The Justice Department has asked a federal judge to clarify the immediate impact of his ruling that declared the new health care law unconstitutional. If Judge Vinson says he intended to halt implementation of the entire law immediately, the government said it would consider seeking a temporary stay at an appellate court. The Justice Department is expected to appeal Judge Vinson’s ruling soon to an appeals court in Atlanta.

    A lawyer representing the states, David Rivkin, said the states oppose the government’s motion and plan to file a formal response Friday.

    Virginia Attorney General Ken Cuccinelli, the plaintiff in one challenge to the law, has asked the U.S. Supreme Court to take the case without waiting for appellate courts. Even if it declines to expedite the case, the Supreme Court could take it up as soon as its 2011-12 term.

    Justice Department spokeswoman Tracy Schmaler said the government filed its motion “to confirm that the court did not intend to disrupt the many programs currently in effect, including small business tax credits, the millions of dollars in federal grants awarded to states to help with health care costs and other ongoing consumer protections while this case is on appeal.”

    In Maryland, Raia, Brown’s press secretary, said “What I was hearing was a partisan commitment to weaken the efforts that have been made to provide affordable health care” to more Marylanders. Waiting would set us back and put us behind the curve,” undermining the administration’s effort to be “a national model” for implementation of the president’s plan.

    Maryland will not begin realizing savings from federal health care reforms until fiscal 2014, according to the Maryland Health Care Reform Coordinating Council.

    In the current budget O’Malley has proposed cutting the state’s Medicaid payments to hospitals by $264 million. Maryland’s soaring pension deficits are racking up $3,069 in debt for every taxpayer in the state. Maryland’s total debt adds up to $4,677 per resident. During a legislative briefing it was noted that $200 million in bond debt would be sold to replace money taken out of the special funds for Program Open Space, Chesapeake Bay Restoration and the Transportation Trust Fund.

    This hardly seems a fiscal environment to risk having to return federal moneys received and/or upend the medical, insurance and taxpayer status.

  • Rcarlson1

    I suggest that the elected leadership in Maryland devote much more attention to getting information out to the public in an “easy to understand” fashion; information that covers the key provisions in the Affordable Care Act relating to changes in the delivery of health care services itself. I suspect that most legislators (and few voters) know little to nothing about the service delivery aspects of the ACA. Its too bad than the “near total” focus of discussion since the ACA enactment has been on the regulatory provisions affecting the insurance industry – however important – and not on the many critically important changes designed to improve the availability, accessibility of services. The legislation introduces a “sea change” in health care that will have an enormous positive impact on the delivery of care with on the health of the community.

    Ron Carlson
    Community Health Advisor