Already Ahead of the Game, Maryland Moves Forward with Health Reform
By Megan Ix, CHHS Research Assistant
Maryland started planning for the full implementation of the Patient Protection and Affordable Care Act (ACA) soon after it was signed into law in 2010, even as critics filed lawsuits claiming it was unconstitutional. Maryland’s swift action has put it ahead of many states in reforming the way health care works. With the law now largely upheld, we wanted to take stock of where Maryland is on the road toward implementing the law, and what has already been impacted since the law passed.
The parts of the ACA that have already gone into effect have made an impact in Maryland. Barring insurance companies from declining coverage on the basis of pre-existing conditions has benefitted nearly 1,000 Marylanders. Allowing children to stay on their parents’ insurance plans until the age of 26 has led to roughly 52,000 young adults keeping or obtaining coverage. Changes to Medicare Part D prescription drug pricing has saved participating Maryland senior citizens more than $53 million; and more than 550,000 seniors on Medicare have benefitted from free preventive services. Additionally, 1.2 million residents are covered by new policies that cover preventive services.
Shortly after President Obama signed the ACA into law, Maryland passed a bill establishing the framework for what will be its health benefit exchange. The exchanges are a central piece of the ACA and promise to create marketplaces where individuals and small businesses can compare and buy insurance plans. Maryland started early in developing its own exchange, and has already received more than $34.4 million in federal grants. Maryland has also received more than $83 million in new funds for school-based health centers, assistance for at-risk families and people with disabilities, student loan forgiveness to build the health care workforce, and other community-based programs as a result of provisions in the ACA.
The U.S. Supreme Court struck down the ACA’s requirement that states participate in the expansion of Medicaid, which is government-funded health care for the poor. Despite that, Maryland plans to move ahead with Medicaid expansion. The General Assembly passed the Working Families and Small Business Coverage Act of 2007, which expanded Medicaid income eligibility for parents and childless adults to 116 percent of the poverty level. The ACA provisions will expand Medicaid coverage to individuals and families within 133 percent of the poverty level.
It is estimated that one-third of Maryland’s approximately 750,000 uninsured residents will gain coverage in the first year that the ACA is fully implemented in 2014. Initial projections show 180,000 Marylanders could access insurance on the exchange in the first year and 84,000 through the expansion of Medicaid. An independent analysis of state projects found that by 2020, full implementation of the ACA would enable Maryland to cut the number of uninsured in half.
Maryland Governor Martin O’Malley has made it clear his state will move full steam ahead with health care reform. However, the Supreme Court decision was still met with mixed reactions. For example, while some small business owners have already seen benefits resulting from the law, others remain concerned about the potential burdens they may face with the affordability of insurance and the penalty for not having health coverage. A number of Maryland political leaders have also reacted to the Supreme Court’s decision.
More information about health reform in Maryland can be found on the Maryland Health Care Reform website.