Obamacare premium costs in Maryland set to jump as state approves rates.

As we watch President Donald Trump and his Republican Congress sabotage Obamacare, many Marylanders have asked “What does this mean for us?” The short answer: We aren’t sure.

But while the proposals coming out of Washington seem to change every hour, the Maryland General Assembly is leading an effort to be prepared for any outcome. Last session, we passed legislation creating the Maryland Health Insurance Coverage Protection Commission. The commission brings together a bipartisan group of health care professionals, advocates and citizens to follow the debate in D.C. and create state policy options to address this crisis.


As you can imagine, this has become a much more personal issue for me after the last six months. Every Marylander deserves the kind of health care I received during my liver transplant. I am fiercely protective of one of Maryland’s great strengths: the best health care delivery system in the world. We are the home to Johns Hopkins, the University of Maryland Medical System, the National Institute of Health and amazing community hospitals like Anne Arundel Medical Center.

That didn’t happen by accident. For 36 years, Maryland has had a Medicare waiver, which allows us to have the nation’s only “all payer” system at our hospitals. Protecting the waiver is a critical function of state government because it means hospitals charge the same rate for services to all patients, regardless of what kind of insurance they carry, and has led to efficiencies in health care delivery that benefit the patient. This has also saved Marylanders billions in health care costs and brought the best health care talent from around the world to our state.

Maryland has also led the way in making sure children have health care insurance. As the chairman of the Economic Matters Committee, I led the General Assembly’s implementation and subsequent expansion of the Maryland Children’s Health Program in 2001. The plan helps struggling families buy health insurance for their children for less than $60 a month.

In 2002, my committee and I led the fight to prevent CareFirst from being acquired by a private insurance company, making sure our state’s largest health care insurer remained a nonprofit whose focus was patient health, not stock prices and profits. As a state, we’ve begun incentivizing patient health — focusing doctors, hospitals and insurers on improving the overall health of their patients and reducing frequent trips to the emergency room for chronic issues.

The way forward for health care

Republicans couldn't muster the votes to repeal and replace the Affordable Care Act; President Trump's suggestion to repeal and delay is an even bigger non-starter.

When Obamacare passed, Maryland had the foresight to create our own health benefits exchange and not rely on the federal government. After a rocky start, we now lead the nation in making sure our citizens have health care insurance. We have the fifth highest enrollment rates for 18- to 34-year-olds and the third best rate of new enrollees in 2017. We’ve take a One Maryland approach to Obamacare — that’s why enrollment rates are the highest in Western Maryland, the Eastern Shore and Baltimore City.

While health care is a huge partisan battle in Washington, D.C., it isn’t in Annapolis. I’m extremely proud of the bipartisan work the General Assembly has done together over the years. We build consensus whenever possible and address the tough issues each year with an eye toward the future. That’s why we’re more prepared than any other state in the union to address the challenges ahead. The state is working to ensure that we retain our waiver while improving health care service delivery and expanding preventive health care services for every patient.

We’ll continue to work with hospitals, doctors, insurers, advocates and our Republican colleagues to attack the opioid epidemic, mitigate the Trump sabotage of Obamacare and protect our state’s health care system and patients.

Michael E. Busch, a Democrat, is speaker of the Maryland House of Delegates. His email is michael.busch@house.state.md.us.