Health care -- what should they do?

Governor Hogan appears to have his fingers crossed that Congress and the Trump administration will work out a deal on CHIP in the course of enacting a new spending deal this month. But if they don’t, he needs to include state funding in his budget to ensure continued health care for 142,000 kids. Otherwise, the state CHIP program will run out of funding sometime this spring. The end of the ACA’s individual mandate portends to worsen the problem of “adverse selection” in the state’s Obamacare marketplace. Younger and healthier people will forego insurance, driving up costs for the older and sicker consumers who don’t have that choice. Rates will increase, more people will drop out, and the cycle will worsen. Maryland can and should enact its own individual mandate to mitigate that problem. The end of cost sharing reduction payments — essentially, compensation for costs insurance companies incur in order to meet Obamacare limits on out-of-pocket expenses for lower-income consumers — will also drive rates up. The state could help counter that by establishing a reinsurance program, as other states have done, to reduce the impact the sickest and most expensive patients have on the risk pool. As for prescription drugs, advocates propose piggybacking on our decades of experience with the Health Services Cost Review Commission to create a price-setting body for certain expensive drugs or those whose prices increase rapidly. It’s a promising concept but not one to be rushed into, given the complexities involved. It may be too heavy a lift to work through the bill in one legislative session.

Amy Davis, Baltimore Sun
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