Officials call for health insurance down payment plan
Penalty for uninsured would go into statewide funding pool
Marylanders without health insurance would be required to pay a state penalty that can go toward purchasing coverage under legislation to be introduced next year by state Sen. Brian Feldman and Del. Joseline Peña-Melnyk.
Proponents touted the plan Nov. 20 at a news conference, followed by a scheduled legislative hearing on health care in Annapolis.
Under the proposal, anyone in the state who reports not having quality health insurance would be required to pay a penalty, similar to the federal mandate that will end in 2019 under changes to the Affordable Care Act.
Maryland’s proposal would allow the funds to go toward purchasing a health insurance plan rather than into a general pool for all Marylanders, said Feldman (D-Montgomery). The federal mandate, on the other hand, goes into a general pool of penalty payments toward covering everyone. “We intend to make enactment of the Health Insurance Down Payment proposal a priority for the 2019 Maryland General Assembly session,” Feldman said. “We must protect Marylanders’ health care coverage and we know that everyone benefits when we expand health care access.”
Del. Matt Morgan (RSt. Mary’s) said during a phone call Nov. 21 that he is on the committee that created the legislation. He said he agrees with former President Barack Obama about making health insurance cheaper and “people want health insurance but can’t afford it.” He said about half of 363,000 people who are uninsured make too much money to qualify for current federal subsidies.
Morgan said legislators should focus on making insurance coverage more affordable rather than implementing another “middle class tax.” He said people shouldn’t be forced to purchase a product they may not use if they are healthy.
According to the fiscal and policy note for House Bill 1167, or the “Protect Maryland Health Care Act of 2018,” payments may be used as a down payment for purchasing coverage under a new Health Insurance Down Payment Initiative. By Jan. 1, 2020, the state comptroller and the Maryland Health Benefit Exchange must develop a specified system to facilitate the down payment initiative.
If an individual fails to maintain health coverage for three or more months of the taxable year, the individual must make a specified payment with the individual’s state income tax return. The fine could be the greater of either 2.5 percent of the sum of the individual’s federal modified adjusted gross income as well as those claimed on the tax return or $695 per adult and $347.50 per child younger than age 18 on the return. The per individual rates must be adjusted annually for inflation.
Morgan said there are a variety of plans available ranging from copper to platinum coverage.
Delegate-elect Brian Crosby (D-St. Mary’s) said during a phone call Nov. 21 that he “wouldn’t look at [the penalty] as a fee” but something for people to invest their money into for health care. He said people can choose to not get insurance and pay the penalty, or buy insurance to increase the number of people paying for health care and “change the slope of the cost.” He said premiums have been on the rise for over 30 years, “long before Obamacare.” He said if more people “are in the pool, it lowers the risk.”
Crosby said younger people “need to pony up” the money for a basic insurance plan to potentially drive down the cost for others who have to have more medical procedures. He said the state’s current “all-payer” system should be considered for a national model because “it’s a more practical approach” than a single-payer model. “We need major reform,” he said.
“I’m not disillusioned by [health care] data from other countries” like those in Europe, Crosby said, adding that those living in the United States pay “twice as much in premiums and have a worse outcome.”
He said “economically ... it’s nuts when you think about it.” He said the variety of ways people can pay for health insurance is a “hodgepodge [and] a Frankenstein system,” and listed how people can be covered by single payer means through Department of Veterans Affairs, employer-based, Medicare and Medicaid plans.
Nearly 80,000 Marylanders would be eligible to gain coverage through paying the state penalty, according to a report from the U.S. Agency for Healthcare Research and Quality and the Maryland Health Services Cost Review Commission.
Feldman said this is a creative proposal that differs from the federal mandate to “ensure more Marylanders have health insurance, and in turn, keeps costs down.”
“When more people enroll in coverage, the costs come down for everyone,” said Peña-Melnyk (D-Prince George’s, Anne Arundel). “More young and healthy people in the individual market means that risk levels are better and premiums are lower. Fewer uninsured means lower uncompensated costs in hospital emergency rooms, which means fewer of those costs get passed on to the rest of us.”
Although premiums have continued to increase in the last five years, those increases are declining each year as more people sign up for coverage.
New data prepared by the Maryland Citizens’ Health Initiative Education Fund reveals that annual increases in the average small group premium in Maryland dropped from 5 percent to below 1 percent since the Affordable Care Act went into effect in January 2014.
The data, reported by the U.S. Agency for Healthcare Research and Quality and the Maryland Health Services Cost Review Commission, affirms that since the Affordable Care Act was introduced in 2014, the uninsured rate in Maryland dropped nearly in half, going from about 12 to 6 percent in 2017.
The annual cost in Maryland of uncompen- sated care — when people without health insurance receive treatment — fell from about $1 billion to $700 million in the same time period, while more than 400,000 Marylanders received insurance.
Peña-Melnyk said a plan like this is essential for filling the gap where the Affordable Care Act’s individual responsibility is being cut off. She said that if a new individual mandate isn’t passed, according to the Urban Institute, about 69,000 Marylanders would lose insurance and individual market premiums would rise about 16 percent.
The Maryland mandate would be used as a down payment for health insurance. For some, it would cover the cost; others would need to supplement that amount.
Public health advocates are hoping to see those costs drop if more Marylanders opt in for coverage. Beth Sammis, president of Consumer Health First, said one of the most difficult aspects of getting a larger pool is motivating young, healthy people to opt in to coverage.
Last year, state legislators attempted to pass the Protect Maryland Health Care Act of 2018, a similar bill that would have required the state to create an insurance stabilization fund and the health insurance down payment escrow fund.
Though the original down payment plan never reached Republican Gov. Larry Hogan’s desk last year, advocates are hopeful this will be a priority in the upcoming legislative session.
Thomas “Tommy” R. Norsworthy, 58, of Hughesville, passed away Saturday, December 1, 2018 surrounded by his family and friends.
He is survived by his wife, Joyce Graves-Norsworthy; sister, Paula Fanning; brother, John Norsworthy Jr. (Denny); and many other family members.
He is preceded in death by his parents, John Norsworthy Sr. and Joanne Beers; siblings: Margaret Blomquist (Dave), Carol Norsworthy, Mary Norsworthy, and William Norsworthy.
Tommy graduated from Ryken in 1979. He was employed with Bob Green Siding for 36 years where he was a foreman. Tommy enjoyed camping, fishing, crabbing, and golfing.
Visitation will be held at Brinsfield in Charlotte Hall on Friday, December 7, 2 p.m. to 4 p.m. and 6 p.m. to 8 p.m.
Arrangements by Brinsfield Funeral Home, P.A., Charlotte Hall, MD.