High-ranking Maryland lawmakers and CareFirst BlueCross BlueShield, the region's largest insurer, outlined yesterday a $1.6 billion proposal for near-universal health care coverage that would require state residents to have insurance and employers to provide it.
The legislation is the latest attempt to help a large segment of Marylanders who don't have health insurance - more than 760,000, or 14 percent of the population - which puts their personal and financial well-being at risk while adding to premiums of other residents who subsidize charity care. It comes as President Barack Obama has undertaken an effort to overhaul the nation's health care system.
Del. Peter A. Hammen of Baltimore and Sen. Thomas M. Middleton of Charles County, Democrats who are leaders on health care issues in the General Assembly, acknowledge that their sweeping plan is unlikely to be approved this year. But they said they wanted to begin a discussion among doctors, insurers and other stakeholders so they might achieve a consensus by next year's legislative session.
Hammen described the bill as an "effort to get to that next step in terms of health care reform." It would build on a plan approved by the legislature two years ago that expanded eligibility for Medicaid, the government insurance program for the poor, and extended subsidies to small businesses to offset the cost of providing coverage.
CareFirst chief executive Chester Burrell said that proposing a bill, even if it doesn't have a chance at immediate passage, "galvanizes attention and action and study that otherwise would not occur."
Efforts to expand health coverage have been ensnared by Maryland's bleak financial outlook in a national recession.
But the proposed legislation, its backers contend, would pay for itself through premiums from a new insurance product created by the bill and redirected health care dollars from other programs. More funding would come from penalties assessed to individuals who remain uninsured and to employers that fail to offer insurance.
The proposal would provide an insurance plan for individuals with premiums of about $250 per month. Sliding-scale subsidies would be available for low-income individuals who don't qualify for government programs such as Medicaid and Medicare.
Residents who don't secure health insurance would pay an additional tax of as much as $1,800 annually. Low-income residents would be exempted from penalty.
Industry and health experts have expressed reservations, an indication of the difficulty of building support for such a plan.
The Maryland State Medical Society raised concerns about imposing penalties on those who don't purchase insurance. And the Maryland Health Care Commission said the proposal could harm the insurance market and draw legal challenges. It concluded in a position paper that the proposal "is not the best option to guide reform."
Lawmakers are considering other proposals aimed at achieving universal health care. One from Sen. Paul G. Pinsky, a Prince George's Democrat, would create a government-run health system for all residents similar to the Canadian and French systems. Another proposal from Del. James W. Hubbard, also a Prince George's Democrat, and the Maryland Citizens' Health Initiative would increase payroll taxes to pay for a Medicaid expansion and create a quasi-governmental insurance pool.
Baltimore Sun reporter Gadi Dechter contributed to this article.