Under the shadow of federal efforts to repeal and replace the Affordable Care Act, the General Assembly this session passed several bills that look to insulate Marylanders from changes to the health insurance law and passed packages of bills designed to combat the opioid crisis and deal with mental health issues.
The legislature passed the Maryland Health Insurance Coverage Protection Act to create the Maryland Health Insurance Coverage Protection Commission, which will “monitor and assess” potential changes to the Affordable Care Act.
The legislature also gave the attorney general the authority to sue the federal government.
“It was a great session for health care for Marylanders because we passed two bills to protect Marylanders from any effort to undermine health care at the national level,” said Vincent DeMarco, president of the Maryland Citizens’ Health Initiative.
The attorney general was also given the ability to sue the makers of generic prescription drugs for price gouging, an effort supported by DeMarco’s group as well as by the Baltimore City health commissioner and the AARP of Maryland.
Dr. Leana Wen, the health commissioner, said sharp increases to the drug Naloxone have come at a time it is needed to combat the state’s opioid crisis.
“It’s unconscionable that the generic prescription drug of Naloxone has more than doubled in price,” she said. “For us, this is a matter of life and death. Nobody should be priced out of saving a life.”
Gov. Larry Hogan declared a state of emergency this year over the opioid crisis, and the legislature passed a package of bills to address the epidemic.
The Heroin and Opioid Prevention Effort (HOPE) and Treatment Act of 2017 addressed the crisis through various methods, including making opioid overdose drugs like Naloxone more readily available and providing the Department of Health and Mental Hygiene more resources to fight the epidemic.
Mental health legislation
The General Assembly also passed several bills to address mental health issues.
The Keep the Door Open Act will provide funds for community-based health providers to address behavioral health. The legislature also provided full funding for institutions for mental diseases, which should help reduce the number of people at hospital emergency rooms.
A law to expand telehealth services to include counseling for substance use disorders also passed.
“(The) top priority (for the Maryland Hospital Association) was behavioral health,” said Jim Reiter, a spokesman for the association.
Another priority for the association will help hospitals and doctors get on the same page for collaborating under what’s commonly called Maryland’s Medicare waiver. It would exempt physicians and providers operating under the waiver from physician self-referral laws.
As hospitals and physicians leave the fee-for-service model in favor of the all-payer model favored by the waiver program, the measure will encourage increased collaboration between doctors and hospitals, Reiter said.
While the hospital association was pleased that several bills it supported passed, officials said they were disappointed that the “spenddown” to reduce the state’s Medicaid tax was skipped this year.
Instead of the planned $25 million spenddown in fiscal year 2018, 2019 and 2020 will see $35 million set aside for the spenddown.
The tax was instituted as a temporary $19 million tax to fund Medicaid in 2009. By 2016 it had reached $365 million.
“It’s really a sick tax,” Reiter said. “It’s a tax that goes into patients bills.”
Payments for the tax count against spending caps that are part of the state’s agreement with the federal government to run the all-payer hospital system.
A smaller bill passed by the legislature could help Evergreen Health as it transitions into a for-profit health insurance provider.
SB 1075 authorized the Maryland Insurance Commissioner to waive the 90-day waiting period between when an acquisition of a nonprofit health entity is approved and when it can begin operation.
It would allow Evergreen to begin operation as soon as its acquisition is approved by the Maryland Insurance Administration.
Evergreen is expected to submit its application by the end of the month to begin that process.