President Donald Trump has signed into law a $1.5 trillion tax overhaul package. Trump touted the size of the tax cut, declaring to reporters in the Oval Office before he signed it Friday that "the numbers will speak."

Lost in the debate about the Patient Protection and Affordable Care Act (ACA) is its role in helping aspiring entrepreneurs build businesses (“Trump’s latest effort to undermine the ACA makes Maryland action all the more crucial,” Feb. 20). Consumer Health First has heard from many entrepreneurs who were able to leave their jobs and start a business because the ACA gave them access to comprehensive affordable health insurance in the individual market.

But recent rate increases in Maryland put entrepreneurs at risk. Take, for example, one Maryland woman we heard from, who took advantage of the ACA and opened her own business. Now her monthly premium has increased from $881 to $1,537. The cost of insurance, she told us, “poses a significant threat to the success of my business, to my family’s health and well-being, and to my financial future.”


The General Assembly is considering a reinsurance program and an individual mandate that will help lower health insurance premiums. However, if this is all that is done we will miss the opportunity to ensure the individual market continues to help aspiring entrepreneurs. That’s why we urge passage of two other important legislative initiatives.

Sen. Thomas M. Middleton and Del. Ariana Kelly introduced the Health Benefit Plan Premium Rate Review Process bill to require insurers to provide additional information during the rate review process. This will help us better understand what’s driving premium increases so we can put public policies in place to make premiums more affordable.

The Medicaid Buy-In Task Force bill sponsored by Delegate Kelly and Sen. Brian Feldman will lead to a state study of the feasibility of allowing consumers to purchase coverage directly from Medicaid, in addition to coverage with private insurers like CareFirst or Kaiser. A Medicaid “buy-in” holds the promise of increasing competition and choice in the individual market and thereby lowering premiums.

The female entrepreneur closed her email to us by saying, “I respectfully request that as you work to protect health insurance in Maryland that you develop a way to provide relief to people like me.”

Consumer Health First believes more information, competition and choice can make individual health insurance coverage an affordable option for Maryland entrepreneurs over the long-term.

Beth Sammis, Annapolis

The writer is a former state acting insurance commissioner and president of the board of Consumer Health First.