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Health reform has been critical for Maryland

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With the Supreme Court reviewing the Affordable Care Act (ACA), there is no shortage of legal analysis to handicap the decision. But unfortunately, not enough attention has been paid to the real value this law provides to millions of American families and businesses.

As governor, I have heard from families unable to purchase coverage at any price because of pre-existing illness, from seniors forced to choose between medications and energy bills and from businesses required to drop employee coverage to stay afloat. These stories represent failures that reach far beyond the individual people harmed. They put us all at risk, for a health care system that supports a healthy workforce at reasonable cost is essential for job growth and our success in the global economy.

Over the last five years, we've taken a number of steps in Maryland to address this challenge. We have provided tax credits to small businesses that offer coverage, enrolled tens of thousands of children in Medicaid through aggressive outreach, and expanded access to care for low-income parents.

But health care costs, access and quality are issues that cross state borders, and we must ultimately act together to solve them. Thus, the ACA provides states with a vital toolbox made effective by the support and resources of the federal government.

At the top of the toolbox: key insurance protections. Chronically ill children can no longer be denied coverage in the private market because of pre-existing conditions. More than 50,000 young Maryland adults have joined 2.5 million across the country to benefit from the new provision permitting them to stay on their parents' coverage until age 26. The law's ban on insurance companies' practice of imposing arbitrary limits on coverage has already given this real protection to more than 2 million Americans.

Recently, Maryland's bipartisan health reform council heard from a young woman with a rare kidney disease who lost her job and insurance in the economic downturn. No carrier in the private insurance market would offer her coverage. She found insurance through a high-risk pool authorized and funded by the ACA — a program that now supports more than 50,000 Americans.

In the middle of the toolbox: support for prevention. The ACA improves coverage of mammograms, colonoscopies and other preventive care. Well over half a million Marylanders have already taken advantage of these services at no cost. Maryland seniors have also saved more than $44 million on prescription drugs that help them stay healthy and out of the hospital. Under the law by 2020 the Medicare "doughnut hole" will be gone.

The ACA also provides significant financial support to states to improve public health and prevention services. Maryland has received more than $83 million in new funds for school-based health centers, assistance for at-risk families and people with disabilities, loan forgiveness to build our health care workforce, and many other community-based programs.

Deeper into the toolbox: systemic reforms due to be implemented in January 2014. The ACA assures that no one will be denied coverage for preexisting conditions. New health benefit exchanges will provide an online marketplace where individuals and small businesses will comparison shop to find high-quality health plans that best suit their needs. Tax credits and subsidies will help make the coverage affordable. As millions more Americans gain coverage, everyone will pay less of the hidden tax that finances uncompensated care. Over time, the exchange will also support innovations in health care that improve outcomes and reduce costs.

Maryland received an Early Innovator grant awarded to states leading the way in building their health benefit exchanges, and the legislation creating our exchange passed with widespread support from insurance carriers, hospitals, providers, brokers, advocates and consumers.

Maryland's progress under the ACA exemplifies how much is at stake in the Supreme Court. If the court strips us of these critical tools, the impact will be felt most deeply in homes and communities far from the corridors of power. Critically ill children will lose coverage, families facing illness will be forced into bankruptcy, businesses large and small will suffer from a less healthy workforce, and costs will keep rising as we all pay the price for uncompensated care.

At stake is a lot more than an abstract legal analysis. At risk are protections and resources critical to healthy families, healthy communities and a healthy workforce. It's a toolbox that is saving lives and one that we should keep.

Martin O'Malley is the governor of Maryland. His email is governor@gov.state.md.us.

Copyright © 2014, The Baltimore Sun
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