Baltimore Sun Sunday

Lawmakers pass multiple health-related bills

Supporters say steps needed to protect Md. consumers

- By Meredith Cohn and Pamela Wood meredith.cohn@baltsun.com twitter.com/mercohn

Health coverage will be easier to secure for uninsured Marylander­s and prescripti­ons could become cheaper for government workers under legislatio­n passed by the General Assembly, which took up a slate of related measures before adjourning for the year.

One law would require the uninsured to check a box on their state tax returns to say whether they’re interested getting health coverage through the state.

The other would establish a board to study the controvers­ial idea of capping prescripti­on costs for state and municipal employees.

Among other health-related bills passed, the legislatur­e also enacted a patient’s bill of rights and sustained funding for a reinsuranc­e program that helps insurers offset costs for the biggest health care users.

Some of the legislatio­n was scaled back to gain passage, but supporters say even incrementa­l steps are needed to protect consumers as the Trump administra­tion works to undermine the Affordable Care Act, which covers millions of Americans and hundreds of thousands of Marylander­s.

The administra­tion recently told a federal appeals court that it agreed with a lower court ruling that the law was unconstitu­tional. Officials asked that the entire law be tossed out.

“We knew the Trump administra­tion and the Republican­s in Congress would take away health insurance from people. We said: ‘We have to protect people in Maryland, even if Trump wouldn’t protect us,’ ” said state Sen. Jim Rosapepe, chairman of the Senate’s Democratic Caucus.

Rosapepe said the bills collective­ly will make a significan­t difference in improving access and affordabil­ity of health care.

Many of the bills won strong bipartisan support, though Gov. Larry Hogan, a Republican, has not said what he will sign. His spokeswoma­n, Shareese Churchill, said he “looks forward to reviewing this legislatio­n when it reaches his desk.”

Among the bills that passed:

The enrollment bill would require those without insurance to check a box on their state tax returns indicating whether they want state officials to determine their eligibilit­y for Medicaid or subsidized health care under the Affordable Care Act and provide informatio­n.

Vincent DeMarco, who leads the Maryland Citizens Health Initiative, said the “easy enrollment” bill will cost the state very little, but could help 120,000 Maryland residents gain insurance.

Sponsors say 50,000 people could qualify for coverage under Medicaid, the federalsta­te health program for those with low incomes, and 70,000 could obtain enough federal subsidies to cover private health insurance. Another 70,000 would likely qualify for partial subsidies.

Under the ACA, known as Obamacare, the state has already covered close to 380,000 Marylander­s, cutting the percentage uninsured in half to about 6 percent.

A state-level mandate to buy insurance or face a penalty, similar to one stripped out of federal law by Republican­s, was dropped.

Legislator­s scaled back plans for a new state board to curb prescripti­on costs.

One version would have allowed the board to cap drug prices deemed excessive. The legislatio­n now calls for the board to conduct a two-year study to determine ways to control high drug costs, including capping drug prices in state and local government health plans.

If the board is given authority to cap those drug costs, it could eventually cap prices in all insurance plans in the state, said state Sen. Brian Feldman, a Montgomery County Democrat who sponsored or supported much of the legislatio­n.

The potential for such price controls faces opposition from the Pharmaceut­ical Research and Manufactur­ers of America, or PhRMA.

“If the Maryland legislatur­e had mandated price controls, state and local employees could have lost access to their choice of medicine or been forced to wait years longer for critical medicines like cancer treatments,” Nick McGee, a PhRMA spokesman, said in a statement. “At the same time, there would have been a chilling effect on new innovation and the thriving biotech industry that supports thousands of jobs in Maryland.”

He said the group believes the commission will “determine price controls are the wrong approach — that this dangerous policy is unconstitu­tional, would put patients’ access to medicines in danger and cannot be implemente­d effectivel­y.”

McGee said the board should look instead at others potentiall­y boosting the cost of drugs such as insurers, pharmacy benefit managers and other middlemen.

Another pharmaceut­ical group successful­ly sued to stop a 2017 Maryland “pricegougi­ng” law that would have allowed the state’s attorney general to challenge big price increases.

DeMarco said the prescripti­on drug board, though scaled back significan­tly, could serve as a first step toward limiting drug prices.

“We’re going to learn a lot and see if there’s really justificat­ion for these skyrocketi­ng prices,” DeMarco said.

“The bill is a big win for our most vulnerable consumers — hospital patients,” said Anna Palmisano, who leads Marylander­s for Patient Rights, a coalition of 26 advocacy groups.

“When the Governor signs the bill into law, it will ensure that all hospital patients are informed of their rights in a manner they understand. Hospital patients will know that they should be treated with compassion and respect, and that they can be a part of decision making about their own health.”

Several other health-related bills passed the legislatur­e. One creates a special open enrollment program for pregnant women so they can access prenatal care and delivery services. Another offers cost controls for consumers whose insurers change their drug pricing. A third gives protection­s for those on medication­s for chronic conditions who change insurance.

The legislatur­e also extended the life of a commission that studies ways to insure more Marylander­s and maintain benefits. A measure to codify consumer protection­s afforded by the ACA in state law was dropped.

“The General Assembly’s actions this year demonstrat­e its continued commitment to building on the gains we’ve achieved under the Affordable Care Act and continuing to make the health insurance system work better for consumers,” said Beth Sammis, president of the advocacy group Consumer Health.

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