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Kathleen Westcoat: Health care ruling impact looms large for state

Media coverage of the U.S. Supreme Court’s pending decision about the constitutionality of the Affordable Care Act has tended to focus on legal issues, such as the individual mandate, or the political implications for President Barack Obama and other national leaders.

But as we wait for the decision, it’s critical to remind ourselves that tens of millions of Americans, including hundreds of thousands of Marylanders, have a profoundly important stake in the outcome of the court case.

For many, a rejection of all or key parts of the law by the court could end any chance of getting the health care they need and can afford. The decision could force others to continue living with the reality that one major illness could bankrupt them.

Striking down the health care reform law would fall hardest on people who are now stuck on the margins of our health care system, such as working families with modest incomes, young people starting out in the workplace but unable to obtain insurance, seniors struggling to pay for prescription drugs and people with pre-existing conditions who have nowhere to turn for coverage.

People who get sick could again face the loss of their coverage, which is prohibited under the new law, small businesses could be hurt with the loss of tax credits for providing coverage to their employees, and people needing substance abuse treatment or mental health counseling could find their coverage drastically scaled back, because parity for the small group and individual markets is tied to the ACA.

Snapshot of the future?

Consider the difference that the health reform law has already made in the lives of Marylanders. Statistics compiled by the U.S. Department of Health and Human Services (and available at show that as of 2011 in Maryland:

-51,868 young adults gained insurance coverage under their parents’ plans.

-52,243 people with Medicare received a 50 percent discount on their covered brand-name prescription drugs when they otherwise would have hit the “donut hole” that spikes their out-of-pocket expenses. The resulting savings: an average of $589 each.

-2,251,000 people no longer have lifetime limits on their insurance coverage.

This is just a snapshot of what the future would hold if health reform is fully implemented in January of 2014. We estimate that it would provide coverage to hundreds of thousands of additional people in Maryland.

A statewide health insurance exchange, now under development, will give Marylanders a better way to choose their insurance and will help hold down costs.

Enormous challenges ahead

Today, the challenge is enormous, with about 750,000 Marylanders uninsured. Every day, our organization, HealthCare Access Maryland, and a range of community-based organizations around the state help families, mostly low-income, obtain health insurance and other supportive services.

More and more, we are seeing families that used to enjoy good health insurance benefits through their jobs but who are now struggling to afford health care after being laid off and losing their coverage. That means doing without preventive services or necessary care.

While some qualify for publicly subsidized programs, many others do not and would be among those who can take advantage of changes promised through the health care reform law.

We are committed to the idea that all citizens deserve the opportunity to obtain health insurance and have ready and affordable access to care. Maryland has been a leader in this effort, thanks to the work of Gov. Martin O’Malley, Lt. Gov. Anthony G. Brown and the General Assembly.

No matter what the Supreme Court does, we must recommit to the task of health care reform in our state and continue working to ensure that all Marylanders have equal access to health insurance.

Kathleen Westcoat is the president of HealthCare Access Maryland, a not-for-profit organization with a mission of connecting people to insurance and care, educating the community about healthier living, and advocating for a more equitable health care system. Her email address is [email protected]