Maryland continued its aggressive implementation of health care change Thursday despite uncertainty surrounding the issue nationally, as the General Assembly passed legislation to create open markets where people will buy insurance.

The law to set up the health benefit exchanges was sent to Gov. Martin O'Malley, who supports the legislation.

Passage of the bills in the House and Senate comes as the U.S. Supreme Court is deciding whether it is constitutional to require everyone to have insurance, a key component of President Barack Obama's overhaul of the health system.

"The Affordable Care Act offers tremendous value to our state, and it is the law of the land," said Lt. Gov. Anthony G. Brown, who is leading the state's effort. "Maryland intends to meet federal deadlines for establishing our health benefit exchange and must take steps now in order to utilize over $34 million in federal grants."

The legislation passed by state lawmakers will guide how the exchanges are operated. It outlines the types of health and dental plans that will be offered and looks at ways to prevent fraud in the system. The bill also addresses ways to reduce costs and improve the quality of the plans after the first two years.

The mandate to buy coverage doesn't go into effect until 2014, when all states will be required to operate exchanges where the uninsured can buy coverage.

About 700,000 Marylanders, or 13 percent, are uninsured, and officials expect at least half to gain some kind of coverage. That would save the state about $1 billion over a decade.

"We think this is a tremendous public health victory for Maryland," said Vincent DeMarco, president of the Maryland Citizens' Health Initiative, a group that works to expand health coverage. "It will help make health care more affordable for all Marylanders."

andrea.walker@baltsun.com

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