Senator Middleton: Expect renewed effort in 2008 to gain health care access expansion

Despite prospects that the 2008 General Assembly session will be dominated by the state’s projected operating deficit, Maryland Senate Finance Committee chairman Thomas M. “Mac” Middleton will continue to seek expansion of healthcare access, he told Greater Baltimore Committee members on September 5.

Senator Middleton met with the GBC’s Healthcare Committee, which last year crafted a GBC proposal to expand Medicaid eligibility in Maryland, expand small business access to a limited health benefits program, and provide a tax credit for employers offering wellness programs.

Middleton praised the GBC for what he called a “gutsy” proposal and urged the GBC to continue its work to develop creative positions on healthcare and other policy matters.

“As a legislator, that’s what I expect out of groups,” he said.

Middleton, who sponsored the GBC’s bill last year, said he will urge lawmakers to include “some” expansion of access to health care plans as part of fiscal decisions in the coming year. He noted that Maryland has as many as 800,000 uninsured residents. He said he favors extending Medicaid access to families whose incomes are moderately above the poverty level in order to address the more than 133,000 children in Maryland without health insurance.

In Maryland, 77,000 uninsured children are in families whose incomes are below 200 percent of the poverty level, according to U.S. Census Bureau data.

No healthcare access expansion bills passed during the 2007 General Assembly session, primarily because of disagreements among legislative leaders over a proposed $1 per pack cigarette tax increase to fund the initiative. The House passed a healthcare bill that included the cigarette tax, but it died in the Senate, whose leadership opposed the tax.

Middleton speculated that, in the 2008 session, healthcare legislation with a cigarette tax could end up being a counterbalancing “bargaining chip” in gaining House support for slots legislation, which the Senate has favored in recent years, but which the House has opposed.

Another emerging healthcare challenge in Maryland is what appears to be declining numbers of doctors willing to participate in health benefit plans, Middleton said. “You can have all of the health programs in the world, but if you’ve got nobody administering them, you’ve got nothing.”

As a result of legislation passed during the 2007, a task force has begun reviewing reimbursement rates to healthcare providers.

The six-member task force, which includes two representatives from GBC-member companies, will examine physician and health care reimbursement trends in the state. Issues task force members are asked to research include options for changing provider reimbursements, the potential for enhancing the ability of physicians and providers to negotiate reimbursement rates with health insurance companies, and whether there is a need to establish a rate-setting system for physicians similar to Maryland’s current rate-setting system for hospitals.

An interim report is due from the task force by December 31, 2007. A final report with task force recommendations is due on June 30, 2008.

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