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Advocates hail session as ‘tremendous victory for public health’

Several of the successful health equity bills this session were sponsored by Del. Joseline Peña-Melnyk. (AP Photo/Julio Cortez)

Several of the successful health equity bills this session were sponsored by Del. Joseline Peña-Melnyk. (AP Photo/Julio Cortez)

A swath of bills that aim to address health inequities in Maryland have successfully passed through the General Assembly this session, including legislation cementing pandemic telehealth expansions into law, a permanent revitalization of a major 2012 public health pilot and medical debt protections.

The Preserve Telehealth Access Act of 2021 passed through both chambers with overwhelming support and was signed by Gov. Larry Hogan on Tuesday. The bill aims to expand telehealth access for Marylanders by qualifying audio-only appointments as telehealth, which allows those without broadband to access telehealth more easily.

It also requires insurers to reimburse telehealth appointments at the same rates as in-person visits, a boon for people who struggle to access face-to-face medical care due to issues with transportation and child care.

The latter provision, as well as the bill’s definition of audio-only service, will sunset in 2023, allowing the General Assembly to use new data and research surrounding telehealth to reevaluate the provisions.

The bill was top priority for the Maryland Hospital Association, which has reported massive increases in telehealth use around the state amid the pandemic.

“COVID laid bare the historic inequities we have within our state,” said Nicole Stallings, senior vice president for government affairs and policy at MHA. “With a legislative session occurring in the midst of a pandemic, health care was front and center.”

Along with the Preserve Telehealth Act of 2021, several other health equity-focused bills this session were sponsored by Del. Joseline Peña-Melnyk, all of which passed. Among her other bills is one that would require certified health officials to undergo implicit bias training, which seeks to reduce subconscious judgements and stereotypes against social groups, like race and gender.

Another, called The Shirley Nathan–Pulliam Health Equity Act of 2021, would create a commission to investigate the role that socioeconomic factors, including housing, transportation, public safety, food insecurity and education, play on health.

If the bill is signed by the governor, the commission will meet four times per year and will be tasked with providing guidance on issues related to health disparities, setting health goals for the state and developing plans to achieve those goals.

The bill generated controversy over its preamble, which highlights medical organizations that have described racism as a public health crisis, notes studies that have linked racism with negative health outcomes and describes race as “a social construct with no biological basis”; nevertheless, the preamble remains in the bill.

Another major success for health equity advocates is a bill that will introduce Health Equity Resource Communities, a revival of the Health Enterprise Zone pilot. The $15 million pilot program ran from 2013 to 2016, significantly reduced inpatient hospital visits and led to new programs that targeted each community’s specific needs.

The bill would allow areas with poor health outcomes to be designated as HERCS with the goal of providing unique resources and programs to meet those communities’ needs, in hopes of reducing health inequities.

Unlike the HEZ pilot, HERCs will be permanent. The bill originally included provisions that would raise taxes on alcohol to fund the program; instead, funds will come from the federal RELIEF Act and the Reinsurance Fund, and will only last until 2025, at which time the General Assembly will have to reassess how to continue funding the program. However, for the program’s preliminary years, the program will receive more funds per year than the original pilot did, at $59 million dollars over the course of three years.

“We are absolutely thrilled. It’s a tremendous victory for public health,” said Vinny DeMarco, president of Maryland Citizens’ Health Initiative and a staunch supporter of the bill.

Other important victories for public health advocates include the assembly’s early override of Hogan’s veto of a bill to levy fees to pay for a prescription drug affordability board and a bill that would protect consumers against certain medical debt collection practices.

 

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