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Proposed health plan promises to expand coverage, reduce costs Hearing suggests bill will fare better than 2 rivals


ANNAPOLIS -- A House committee finished yesterday a grueling three-day marathon on health care reform by examining a plan supporters say will expand health care coverage and lower costs by empowering the consumer.

The system, known as the tax "credit/voucher plan," or "consumer choice," would require every Marylander to buy health insurance and every company to offer it.

But instead of leaving the burden of payment largely in the hands of employers, House Bill 376 would give everyone a sufficiently large tax credit or tax voucher to buy the coverage himself, according to its proponents.

Judging by the numbers of supporters and opponents at yesterday's hearing, the consumer choice bill has better odds of winning the approval of the House Economic Matters Committee, which is considering the health care reforms, than do the other two major bills presented to the legislature this year.

Those bills are a Canadian-style "single-payer plan," under which a state-appointed board would set an annual budget for health care expenditures and pay all claims, and the "employer play-or-pay" program, which would require employers to provide health insurance or pay into a fund that would be used to help cover the uninsured.

Consumer choice resembles President Bush's tax credit proposal, unveiled last week, in that it attempts to make the health care system more competitive and efficient by having people shop for their own health insurance. No longer would receiving medical care be divorced from paying for it.

But unlike the president's plan, the bill would make the tax credits and vouchers available to everyone, not just those of modest means.

And it would pay for those credits by eliminating federal and state tax exemptions on employer-sponsored health benefits and by imposing a 4 percent state payroll tax on employers, said Carl Sardegna, chairman of Blue Cross and Blue Shield of Maryland Inc. and an architect of the consumer choice idea.

Further, all Medicaid recipients would receive the vouchers and, therefore, the same level of care as everyone else.

Supporters include the Maryland Chamber of Commerce, the Medical and Chirurgical Faculty of Maryland (the state physicians society), the AFL-CIO, the Maryland Hospital Association and various health care provider groups.

Retail merchants and commercial insurers were mildly opposed to the measure, and consumer groups and advocates for the elderly were adamantly against it.

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