Calvin Pierson, Dr. Willarda Edwards

Hospital Association President Calvin Pierson and Dr. Willarda Edwards discuss their change in support of the governor. (Sun photo by David Hobby / January 4, 2005)

After fighting alongside Gov. Robert L. Ehrlich Jr. for malpractice reform, leaders of the state's doctors and hospitals stepped away from the governor yesterday, urging him not to veto the malpractice bill passed by the General Assembly last week.

MedChi, the state medical society, and the Maryland Hospital Association said the immediate relief that the bill provides doctors on skyrocketing insurance premiums was essential and warned they would support an override if Ehrlich carries out his announced intention to veto the bill.

"Maryland's health care system is in a crisis," Dr. Willarda Edwards, a Dundalk internist who is president of MedChi, said at a joint news conference. The bill, which cuts premium increases this year from 33 percent to 5 percent, "will enable physicians to continue to care for their patients."

Later in Annapolis, Ehrlich reiterated his veto vow, saying the legal reforms in the bill were "light as air" and its 2 percent premium tax on health maintenance organizations to subsidize malpractice insurance amounted to a tax on the poor.

He said that if the veto were sustained he could offer "short-term cash and hope" by including funds in his budget for some relief in premium rates, although not as much as provided in the legislation.

Vetoing the bill after physicians groups urged him to allow it to become law could be politically difficult for the governor, who did much to bring the malpractice issue to the forefront by touring hospitals, meeting with doctors and urging them to lobby legislators on the issue.

Democrats quickly seized on the situation to depict Ehrlich as isolated in his opposition.

"The physicians support the bill. The hospital association supports the bill. Med Mutual, the insurance company that insures 85 percent of the physicians in the state, supports the bill. The trial lawyers, they're not crazy about the bill ... but they realize it could have been much worse, so they're standing solid," said Senate President Thomas V. Mike Miller.

"Basically, there's no naysayers, with the exception of the one on the second floor," Miller said, referring to the location of Ehrlich's State House office.

Ehrlich has until Monday to veto or sign the bill or allow it to become law without his signature. If he follows through on his veto pledge, the legislature will have the opportunity to attempt to override the veto as its first order of business when the regular General Assembly session convenes Wednesday.

Both houses passed the bill with veto-proof majorities, and Sen. Brian E. Frosh, the Montgomery County Democrat who chaired the Senate's medical malpractice task force, said he expects the legislature would vote to override.

"There are some Democrats that are so upset at how [Ehrlich] handled this special session that they think if he vetoes this we should just let him stew in it, but I think that would be a mistake," Frosh said.

At yesterday's news conference, the medical and hospital associations made their break with Ehrlich a gentle one, praising him for his efforts that led to the bill's passage and agreeing that further reforms are needed.

But they said they didn't have a difficult time deciding what stance to take.

"It was not a close call, in that we need to move forward," said Calvin Pierson, president of the Maryland Hospital Association. "The bill gives relief to physicians by stabilizing their insurance premiums and raising Medicaid physician fees. While the bill falls short of tort reform, it does contain some important steps."

If the legislature sustains his veto, Ehrlich said, he would budget $30 million a year for the next three years to limit malpractice increases - an amount equal to that in an Ehrlich bill killed by both houses in last week's special session. That would limit the rate increase this year to about 12 percent.

Ehrlich has said in the past that he would support a subsidy on doctors' premiums only if it were accompanied by limits on lawsuits, known as "tort reform."

Ehrlich also said he would include $18.5 million in the budget to increase Medicaid reimbursements for doctors in certain specialties - up from $12 million in the bill the governor presented to the special session.

That's about as much as in the first full year of the legislature's bill, but the legislature would increase the amount going to rates (and decrease the amount going to subsidize premiums) in the three years to follow.