Pandemic exposed weaknesses in health care system | COMMENTARY

The COVIID-19 pandemic has further exposed weaknesses in the health care system.

The viral pandemic that is causing damage across the country and around the world has made painfully clear that our health care system needs strengthening, starting here in Maryland.

Don’t get me wrong. Our state has been a leader in advancing innovative ideas to expand health care access, bring down costs and help people lead healthier lives. By fully implementing the Affordable Care Act (ACA), we have brought health care coverage to over 400,000 previously uninsured Marylanders and brought down our rate of uninsured from 13% to 6%. We are all better off when more people have insurance because less of our insurance premiums have to go to pay for uncompensated hospital care. It’s a record we should be proud of.


And this year, the General Assembly took another important health care policy step.

The legislature acted aggressively to enshrine key principles of the Affordable Care Act (ACA) in state law — even as some, including the Trump administration, are pushing in court to throw out the entire law. If they prevail in court, millions of Americans could lose their insurance and the critically important protections established by the ACA. It is unconscionable that some of our leaders are working to undermine our health insurance system during the worst public health crisis in decades.


Fortunately, the new state law establishes that certain components of the law — such as a ban on discriminating against people with preexisting health problems — would remain in place in Maryland, even if the ACA is overturned by a court. This was a bold step and Maryland is a leader among the states in protecting the ACA’s incredibly important provisions. Even if, as we hope, the Supreme Court upholds the ACA, this new Maryland law will protect these health safeguards from the constant attempts by the Trump Administration to undermine them. We thank the lead sponsors Dels. Shane Pendergrass and Joseline Peña-Melnyk and Sen. Brian Feldman, and the bipartisan group of legislators who voted for this measure.

Just as this measure was passing, the coronavirus outbreak hit Maryland. Like all states, many people across Maryland lost jobs and health insurance — at a time when the coronavirus infection rate was climbing.

The Maryland Health Benefit Exchange, which oversees our online health insurance marketplace, has done an outstanding job of holding a special enrollment period to make it easier for people to sign up for insurance. And the state’s Easy Enrollment program for which we advocated has been used by tens of thousands of Marylanders who simply checked a box on their income tax return to launch the enrollment process. Both of these programs end on July 15 so if you are uninsured we urge you to go to or check the box on your tax return.

We should build on that by adding a similar program into the state’s unemployment insurance applications, so that newly unemployed people can start the health insurance enrollment process.

While the ACA has been incredibly successful at getting people enrolled in plans, the reality is that the cost of insurance remains high for some individuals.

To address that, the state must look carefully at creating new subsidies for individual insurance policies, supplementing the federal subsidies, which often don’t go far enough. The Maryland Health Insurance Coverage Protection Commission has examined this idea, and officials from Massachusetts briefed the commission on how successful that state’s subsidy program has been.

While Maryland has decreased its uninsured rate significantly, Massachusetts has done an even better job and has brought their uninsured rate down below 3%. We should also consider new subsidies to help small businesses afford health care coverage for their employees.

With so many people going through economic challenges and losing health insurance, the state must redouble its effort to get as many people insured as possible. Getting more people covered brings down the cost of uninsured care provided by hospitals and doctors; and the bigger and more diverse the insured population is, the lower the premiums are for everybody.


We urge state leaders to look ahead and act aggressively to expand access to insurance and care and ensure Maryland’s health system remains strong as we battle this public health crisis.

Vincent DeMarco ( is president of the Maryland Citizens’ Health Initiative.