O'Malley Administration Pushes for Action on Medicaid Expansion Now
By Andy Zieminski
Thursday, Nov. 1, 2007
ANNAPOLIS - Administration officials urged lawmakers Thursday to take action on Gov. Martin O'Malley's $210 million plan to expand Medicaid access for low-income Marylanders, and not wait until the January regular session to act.
Officials said the plan, which could eventually insure an extra 100,000 Marylanders, is fiscally responsible and "a necessary first step" to universal health coverage in the state.
But some lawmakers at Thursday's joint hearing of the Senate Finance and the House Health and Operations committees questioned the urgency of a bill that would not take effect until July, particularly as they are trying to close a budget gap of up to $1.7 billion.
"I got tons of stuff to look over right now," said Sen. Allan Kittleman, R-Howard. "And I'm being asked to look at this legislation, which is pretty significant legislation. I'm wondering how I am going to give this the scrutiny it deserves when I have to focus" on O'Malley's proposals to fix the deficit.
State health officials insisted the program is needed to help make health care more affordable for everybody in Maryland.
"This is all about being grown up about our responsibilities, and largely that is that we have to live up to the society that we expect and hope to have, and be responsible about paying for it," said State Health Secretary John Colmers to the committees.
The "Working Families and Small Business Health Coverage Act" would expand Medicaid coverage to an estimated 30,000 parents in fiscal 2009 and devote up to $30 million a year to helping small businesses offer their workers health insurance.
The bill would raise income eligibility for parents and caretakers of dependent children from 35 percent of the federal poverty level to 116 percent, or about $20,000 for a family of three. In future years it would extend the same coverage to adults without dependent children, who are now ineligible for Medicaid.
The expansion would be funded from a $75 million surplus in the Maryland Health Insurance Plan Fund, an estimated $56.7 million in federal money and anywhere from $54 million to $85 million from the state's general fund.
Colmers said the plan is sustainable long-term because enrollment can be capped and other coverage elements will be phased in depending on the availability of funds.
"This program is designed, very explicitly, to be pay-as-you-go," he said.
But Republicans questioned the wisdom of taking millions from the general fund, money that depends largely on the passage of O'Malley's other plans, including increases in the sales tax and corporate income tax.
"This money could be used for deficit reduction, but it was his (O'Malley's) policy decision to go without having the revenue," said Sen. E.J. Pipkin, R-Queen Anne's.
"I just want to make it clear that at the end of the day, all roads lead to higher taxes, and we will make that decision as a General Assembly," he said.
Carolyn Quattrocki, an O'Malley aide, said the governor wanted to push his health bill now, at the same time he proposed doubling the tobacco tax to $2 per pack, because the two issues had been linked before.
"It didn't seem right to him to be asking you all to raise that tax as a means to raise revenue without moving forward on health expansion at the same time," she told lawmakers.
A similar bill that would have expanded Medicaid income eligibility to 116 percent of the federal poverty limit passed the House in this year's regular session but failed in the Senate because it would have been funded by a tobacco tax increase.
The current version would not require dedicated tobacco tax revenue. The governor "has made the commitment to fund this out of general funds," Quattrocki said.
But the measure is not independent of action on the governor's tax package. Joseph Bryce, O'Malley's chief legislative officer, said he doubted the General Assembly would pass the Medicaid expansion if the budget problem does not get solved this month.