Expanding Access to Affordable Health Care

As we enter the third year of the Covid pandemic, it is clearer than ever that all Marylanders need accessible, affordable, and equitable health care. The League of Women Voters of Maryland supports the position that healthcare is a basic human right and every U.S. resident should have access to a basic level of care that includes the prevention of disease, health promotion and education, primary care (including prenatal and reproductive health), acute care, long-term care, and mental health care. 

After passage of the federal Patient Protection and Affordable care Act (ACA) in 2010, the percentage of uninsured Marylanders fell. Substantial gains in health care coverage were made due to enrollment in qualified health plans through the Maryland Health Benefit Exchange, as well as due to the expansion of Maryland Medical Assistance (Medicaid).  

Per the Maryland Legislature’s Issue Paper for the 2022 Legislative Session on Health and Health Insurance, 6% (>360,000) of Marylanders remain uninsured. The League will support key legislative efforts in the 2022 Maryland General Assembly session to reduce that number, and increase health care access, affordability, and equity. 

Legislation will be introduced to assist small businesses to offer their employees health insurance coverage by allocating federal funds to subsidize the cost of healthcare premiums.

 As noted in the  1/3/2022 Baltimore Sun Guest Commentary by Senator Katie Fry Hester, and Delegates Robbyn Lewis and Brooke Lierman:

 Only 37% of small businesses in the state provide health coverage, compared to 95% of large employers. Workers at those small businesses must either pay for coverage themselves or go without, leaving them exposed to major health costs. This is a matter of equity. Maryland has the highest per capita rate of small businesses owned by people of color in the nation.

Legislation is being drafted that would allow certain undocumented Maryland residents, including pregnant women and children who have aged out of foster care, to apply for health coverage through the Maryland Health Exchange, CHIP, and Medicaid. A large percentage of the >360,000 Maryland residents without health insurance coverage are non-citizen immigrants. Being prohibited from health care coverage through both the Health Benefit Exchange and Medicaid, these patients must obtain medical care and medications at clinics with limited capacity and funds to assist them. Thus, these patients are also often forced to come to hospital Emergency Departments for non-emergency care: the most expensive option for them, for hospitals, and for the State of Maryland. 

Additionally, with the stress and isolation caused by the pandemic, both adults and children are more at risk for mental health problems, and thus more in need of behavioral health services. Per a 10/29/2021 Baltimore Sun article, the CDC reported that “Maryland and the United States saw record-breaking numbers of fatal overdoses [in 2020]…. Maryland suffered its worst year on record as 2,773 people died of drug and alcohol overdoses in 2020, the highest number ever recorded.” 

The League supports legislative efforts being introduced this year which seek to address these behavioral health challenges. Some of that legislation includes:  

HB56: Commission on Behavioral Health and Mental Health Treatment would establish a Commission on Student Behavioral Health and Mental Health Treatment to study, evaluate, update and revise guidelines for student behavioral health and mental health treatment and practices.

The Covid pandemic has proven that we are all in this together. We must work to ensure everyone’s physical and mental health and safety if we are to stay safe and healthy ourselves. Increasing the number of Marylanders with access to affordable, equitable healthcare keeps more of us safe, ensures the best health outcomes, decreases the burden on our overwhelmed hospital Emergency systems, and keeps down the cost of healthcare in our State by reducing the costs of uncompensated care. 

HB6/ SB150: Maryland Medical Assistance Program Dental Coverage for Adults proposes expansion of Medicaid coverage to include dental care. Lack of  adequate dental care can contribute to broader, untreated infections that further stress resources in already crowded Emergency Departments. Expanding access to dental coverage provides access to preventive services that can improve the health of Marylanders while reducing unnecessary, high cost emergency treatment.