By Len Lazarick

As Maryland seeks to implement a key element of federal health care reform, doctors, insurance brokers and business groups are advocating less government control, while consumer and health care advocates want more consumer protections and voice in a new state agency.

The groups testified Tuesday on an O’Malley administration bill to create a “health benefit exchange” as a new government agency to deal with health insurance.

Federal health care reform requires states to create the new entities to help people with low incomes and no health insurance obtain it on the open market, and to aid individuals and businesses in finding the best insurance plan.

After a hearing in the House Health and Government Operations Committee, chairman Pete Hammen said that he hoped “in the end, we could all agree on a set of amendments” that would satisfy most of the concerns.

But he also predicted that it would wind up being “an independent government-run exchange,” that is “not dominated by special interests.”

Representatives of the state medical association, the Maryland Chamber of Commerce, the National Federation of Independent Business, and the Maryland Retailers Association all favored creation of a nonprofit corporation to run the exchange. Insurance brokers who now handle most of the health coverage for small businesses were particularly concerned that a new government agency would seek to take business away from them, as had happened in Massachusetts.

“We’re concerned by the size and scope and power of the exchange,” said Bryson Popham, a lobbyist for the brokers. But, he said, “a constructive dialogue has been begun.”

“It is not our intent to make the broker-client relationship go away,” Lt. Gov. Anthony Brown assured the committee, noting that the brokers employ tens of thousands of people.

Jay Schwartz, representing the medical association, said he could foresee some kind of strange hybrid agency with some of the features of a public body and private nonprofit.

But Deb Rivkin testifying for CareFirst, the largest health insurer in the state, wanted the health benefit exchange to be “an independent unit of state government.”

Hammen said he was also concerned about the proliferation of councils, commissions and agencies dealing with health care.

The various stakeholders are continuing to meet with Brown, Hammen, administration officials and committee members to hammer out a compromise.