For the past two years, the federal government has tried every way it can to undermine the Affordable Care Act (ACA), the critically important legislation that has led to millions of Americans obtaining health insurance.
Despite this onslaught, Maryland has fought back to protect its citizens, most recently with the state’s reinsurance program to help stabilize the individual marketplace. This important step has already led to reduced premium costs. However, much more needs to be done to ensure all Marylanders have access to affordable health care.
That’s why I plan to introduce legislation in the General Assembly known as the Health Insurance Down Payment Plan, which would allow uninsured Marylanders to purchase insurance, get the care they need and hold down costs for everybody in the insurance marketplace.
Here’s how it works: At tax time, Marylanders will be asked if they had quality health coverage in the past year. If the answer is no, they have a choice to either pay a penalty to the state or use that money to purchase quality, affordable health care in the individual market, rather than write a check to the state or federal government. This would encourage people to get the insurance they need, encourage younger, healthier people to join the market and keep premiums down for all people in the insurance pool.
This is important because if there are only people with expensive health conditions in the market, costs go up across the board. That’s why encouraging everyone to take responsibility for insuring their health care is a necessary part of stabilizing the health insurance system. Unfortunately, the federal government has stopped enforcing the ACA’s individual mandate. If you own a home purchased with a loan you are required to purchase fire insurance, and liability insurance if you own a car. Health insurance is just as important to protect yourself and to protect society from the burdens of uninsured health expenses.
With our down payment plan, experts predict about 78,000 Marylanders could purchase coverage for no more than the penalty combined with federal subsidies. In addition, more than 50,000 Marylanders would be newly enrolled in the state Medicaid program.
Having health insurance is essential for every individual. But, increasing the pool of people who are insured helps the whole system. When people go without health coverage and they get sick or injured, they are more likely to obtain essential medical care in the most expensive way possible — from hospital emergency rooms. When they inevitably can’t pay the bill, those unpaid costs, known as uncompensated care, drive up everyone’s insurance premiums. When more people get insured, uncompensated care drops and health care premiums become more affordable.
After the ACA launched in 2014, insurance premiums for Maryland small businesses increased more slowly than in previous years, rising by just 0.9 percent a year from 2013 to 2017 for single coverage compared to 6 percent from 2008 to 2013. At the same time, the annual cost in Maryland of uncompensated care fell from about $1 billion to $700 million, while more than 400,000 Marylanders received insurance.
The down payment plan would help maintain and strengthen our system. It would cover thousands of low- and moderate-income uninsured Marylanders, help lower private health insurance costs, stabilize the state’s individual insurance market and point the way to a better approach for other states. As more people sign up, uncompensated care will also continue to decline, further reducing this hidden health care tax and bringing down premiums for everyone.
In the coming session in Annapolis, I will be working closely with state Sen. Brian Feldman of Montgomery County who will be the lead Senate sponsor for the down payment legislation and the Maryland Citizens’ Health Initiative, which has brought together a broad coalition of groups who support putting Maryland residents’ health first.
We cannot let the progress we’ve made in stabilizing insurance rates be undercut by the reckless actions of the federal government. This bill will be a priority of mine in the 2019 legislative session and I urge my colleagues in the General Assembly to join me in fighting to protect health care for all Marylanders.