Future of Af­ford­able Care Act in Mary­land is un­cer­tain


Cap­i­tal News Ser­vice

— While Pres­i­dent-elect Don­ald Trump vowed to re­peal the Af­ford­able Care Act on the cam­paign trail, his re­cent prom­ises to main­tain key com­po­nents of the law have re­as­sured Mary­lan­ders, though many still feel the law’s future is ques­tion­able.

Mem­bers of Mary­land’s Demo­cratic con­gres­sional del­e­ga­tion have warned Trump about in­ter­fer­ing with Oba­macare, though the pres­i­dent-elect has said he plans to keep parts of the law that en­sure cov­er­age for peo­ple with pre­ex­ist­ing con­di­tions and grant peo­ple younger than 26 per­mis­sion to re­main on their par­ents’ plans.

“I think Repub­li­cans need to be very care­ful be­cause the re­al­ity is that the unin­sur­ance rate in Mary­land and around the coun­try is at a low,” Sen­a­tor-elect Chris Van Hollen (D) told WBAL News.

In Mary­land, 120,145 peo­ple were signed up for cov­er­age un­der the Mary­land Health Con­nec­tion ex­change as of Fe­bru­ary 2015, and peo­ple cov­ered un­der Medi­care have saved al­most $230,365,408 on pre­scrip­tion drugs with Oba­macare since the pro­gram was started, ac­cord­ing to the U.S. De­part­ment of Health and Hu­man Ser­vices.

In 2009 — be­fore Oba­macare took ef­fect — 24 per­cent of peo­ple liv­ing in poverty in Mary­land were unin­sured, while in 2014, 15.7 per­cent were unin­sured, ac­cord­ing to data from the U.S. Cen­sus Bureau.


Bruce Op­pen­heimer, a pub­lic pol­icy pro­fes­sor at Van­der­bilt Univer­sity, said peo­ple who would be stripped of their Af­ford­able Care Act ben­e­fits might feel more con­cerned.

“They do not want un­cer­tainty, so they’re go­ing to be ask­ing for — where is it go­ing to go,” Op­pen­heimer told the Univer­sity of Mary­land’s Cap­i­tal News Ser­vice. “OK, you’re strip­ping this away. What are we go­ing to have left? Are we re­turn­ing to health care the way it was be­fore the Af­ford­able Care Act, or is some­thing else go­ing to come in its place?”

With a Repub­li­can White House and a Repub­li­can Congress, it’s pos­si­ble that leg­is­la­tion to re­peal the Af­ford­able Care Act could be in­tro­duced as early as next year.

Med­i­cal pro­fes­sion­als in Mary­land are in fa­vor of Oba­macare’s ex­pan­sion of Med­i­caid, but are look­ing to the new ad­min­is­tra­tion to con­sider some changes within the Af­ford­able Care Act, said Gene Ran­som, the chief ex­ec­u­tive of­fi­cer of MedChi, the Mary­land state med­i­cal so­ci­ety.

“We don’t want to keep things that cre­ate bar­ri­ers be­tween a physi­cian-pa­tient re­la­tion­ship,” he said. “We’re see­ing this as an op­por­tu­nity to look at it and maybe try and make things bet­ter.”

Among the com­po­nents MedChi is look­ing to roll back in­clude the In­de­pen­dent Pay­ment Ad­vi­sory Board, a panel re­spon­si­ble for en­forc­ing a limit on Medi­care spending in­creases.

“We don’t think the gov­ern­ment bu­reau­crats should be de­cid­ing what ser­vices are de­liv­ered to the pa­tient,” Ran­som said. “It should be de­cided by the physi­cian and pa­tient, not some­one sit­ting in an of­fice in Washington.”

But any changes to the Af­ford­able Care Act aren’t go­ing to hap­pen overnight, said Leni Pre­ston, pres­i­dent of Con­sumer Health First, an or­ga­ni­za­tion launched in May to con­tinue the work of the Mary­land Women’s Coali­tion for Health Care Re­form.

“When we woke up on Wed­nes­day morn­ing (af­ter the elec­tion), our agen­das changed com­pletely,” she said. “In­stead of con­tin­u­ing to move for­ward, we are now look­ing at an agenda that re­quires us to look care­fully at those state laws and those state reg­u­la­tions and make sure that we can pro­vide poli­cies and ad­vo­cacy to make sure that Mary­land keeps mov­ing for­ward.”

Mary­land’s use of a state-based ex­change might work in the state’s fa­vor to en­sure some pro­tec­tions un­der the Af­ford­able Care Act, but noth­ing is for sure, said Pre­ston.

“It’s incredibly com­pli­cated; there are a lot of play­ers from the pres­i­dent-elect on down and there are a lot of mov­ing parts that peo­ple are go­ing to be watch­ing out for,” she said.

If the Af­ford­able Care Act were to be com­pletely re­pealed, it could be sal­vaged at the state level — but only if Gov. Larry Ho­gan de­cided Mary­land would cover the cost of the pro­gram.


Cur­rently, the fed­eral gov­ern­ment cov­ers 59.8 per­cent of the cost of the pro­gram in the state, while Mary­land is re­spon­si­ble for the other 40.2 per­cent of the fund­ing, ac­cord­ing to data from the Kaiser Fam­ily Health Foun­da­tion.

How­ever, Mary­land is “sev­eral months out” from being able to tell just ex­actly what Trump’s im­pact on Oba­macare will be, said Chris Gar­rett, the di­rec­tor of com­mu­ni­ca­tions for Mary­land’s De­part­ment of Health and Men­tal Hy­giene.

“It’s way too pre­ma­ture for us to be able to lay out spe­cific changes to the Med­i­caid pro­gram as it per­tains to the new ad­min­is­tra­tion, be­cause the pres­i­dent- elect hasn’t been in­au­gu­rated yet,” he said.

Se­nate Mi­nor­ity Whip Dick Durbin ( D- Ill.) is hop­ing that Trump’s softer com­ments about Oba­macare dur­ing his Nov. 13 in­ter­view with CBS News’ “60 Min­utes” could mean re­form to the law in­stead of com­plete erad­i­ca­tion.

In the in­ter­view, Trump called the stip­u­la­tion to en­sure cov­er­age to peo­ple with pre­ex­ist­ing con­di­tions one of the pro­gram’s “strongest as­sets,” in ad­di­tion to the rule that al­lows peo­ple younger than 26 to re­main on their par­ents’ plans.

“If Pres­i­dent-elect Don­ald Trump is se­ri­ous about pre-ex­ist­ing con­di­tions, he has just re­ally taken a ma­jor step to­ward keep­ing a big el­e­ment of Oba­macare,” Durbin said. “You can­not have that pro­tec­tion with­out a large pool of in­sured peo­ple.”

Ches. City Ec­u­meni­cal As­so­ci­a­tion to host toy give­away

— Fam­i­lies need­ing a lit­tle Santa help this Christ­mas are in­vited to a free toy give­away this Satur­day from 10 a.m. un­til 2 p.m. at St. Basil’s Fel­low­ship Hall.

Ch­e­sa­peake City Ec­u­meni­cal As­so­ci­a­tion is mak­ing the toys avail­able on a first come, first served ba­sis. One new toy and two gen­tly used toys will be given per child to fam­i­lies in need. The hall is lo­cated at 227 Basil Ave.

For more in­for­ma­tion, or to do­nate toys to CCEA for this event call 410-885-3244.

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