2008 Session of the Maryland General Assembly - How Did Health Care Fare?

Tuesday, July 1, 2008

(Nancy Weber) -- During the 2008 session of the Maryland General Assembly, there were 119 bills introduced that addressed health in Maryland. The bills that passed will impact access to care for Maryland residents and especially Howard County. The most important bills affecting Howard County are Senate Bill (SB) 852 and House Bill (HB) 872 which passed unanimously.

These companion bills are essential for the development of Healthy Howard, a public-private partnership, to offer health care coverage to individuals up to 300% of Federal Poverty Level (FPL) in the County. In Maryland, insurance carriers must meet certain financial requirements such as maintaining specified levels of capital reserves. Since Healthy Howard does not fit the traditional model of insurance carrier and complying with these requirements would place an undue burden on the program, legislation was sought to regulate this new type of public-private program. Passing this legislation was critical to the implementation of Healthy Howard slated for October 2008.

Other important legislation passed includes:

FY 2009 Budget – The budget increases funding for Medicaid, Maryland Child Health Insurance Program (MCHP) and Primary Adult Care program by $425.3 million or 8.7%. Inflation and utilization patterns account for 5.4% and increased enrollment accounts for 2.7% of the increase.

Working Families and Small Business Health Care Coverage Act of 2007 – This act, passed during the 2007 Special Session in November 2007, expands Medicaid coverage to parents of eligible children to 116% FPL, expands the Primary Adult Care program staged over three years and establishes a Small Employer Health Insurance Premium Subsidy Program.

Oral Health Safety Net Program – This program, established in 2007, will receive $16.1 million dollars to implement the following recommendations:

$14 million to increase Medicaid dental reimbursement rates which are below the 25th percentile of the American Dental Association’s South Atlantic region rates.
$1.4 million to improve the public dental infrastructure through grants to local health departments, federally qualified health centers and non-profit organizations.
$700,000 to improve school based dental health services.

HB 462 – This bill extends the termination date and will allow self-employed individuals continued access to affordable health insurance.

HB 1176 – This bill establishes a committee on childhood obesity within the Department of Health and Mental Hygiene (DHMH) to study insurance reimbursement patterns for the disease as well as develop statewide data collection and analysis capacity, identify best practices, increase public awareness and childhood obesity screenings.

HB 1391, The Kids First Act – This act requires taxpayers, beginning with tax year 2009, to indicate on their tax return whether each dependent child for whom an exemption is claimed has health insurance coverage. A companion bill, HB 115 requires that DHMH, the Comptroller and State Treasurer develop one sentence statements advising the tax payer that individuals at certain income levels who cannot afford health insurance may be eligible for Medicaid or MCHP. This will increase community awareness and enrollment in Medicaid and MCHP.

HB 1522 - This legislation provides for a continuance of this stabilization fund which supports adequate reimbursement rates for health care providers serving the Medical Assistance population. This is a critical access issue when providers will not accept Medical Assistance reimbursement rates because they are typically below the actual cost of providing the service.
SB 906 / HB1492 – These companion bills create an annual subsidy of $4 million for the Medicare Part D coverage gap and provide a sunset extension for the Senior Prescription Drug Assistance Program (SPDAP) to December 31, 2009.

Other bills that would have improved access to care failed in the legislature because of their fiscal notes. During the fall 2007, the General Assembly met to address a $1.7 billion dollar structural budget deficit for Maryland. Like most states, Maryland is required to have a balanced budget each year. Through a series of budget reductions and revenue enhancement, it was anticipated that the structural deficit would be resolved by 2010.

However, during the fall and winter of FY 2008, an additional $440 million in revenue short fall occurred due to lower than expected revenues from sales and fees due to the mortgage crisis. It is likely that these revenue shortfalls will continue to impact Medicaid and health care access in general in the coming fiscal years. Further, with economic difficulties and housing foreclosures, it is anticipated that more people will lose jobs and health insurance coverage increasing the number individuals and families needing assistance.