Eric Naumburg, M.D., M.P.H.June 23, 2010

Network of Spiritual Progressives

Health Reform and Maryland

Slides Nos. 3 -10 from Physicians for Nation Health Program’s

ShortSet11_09, Slide Presentation at www.pnhp.org

Main Provisions of Maryland Health Security Act 2010

• Publicly financed and privately delivered• All Marylanders are covered, its universal • No financial barriers to access to medical care, no co-pays, no deductibles • Providers and Patients make medical decisions, not insurance companies• All Maryland providers are “in-network”, no being forced to change provider• Covers all necessary medical care, dental, vision and long-term care • Potential savings from decreased administrative costs and bulk buying are enormous; enough to pay for reform without increasing total medical expenditures• Incorporates funds from all federal programs if possible, e.g. Medicare, Medicaid, SCHIP, VA, FEHBP, etc.• Pays for transition costs for displaced workers• Only the State system is allowed to insure basic medical needs; only way to assure necessary savings to pay for universal, expanded coverage• Will end medical bankruptcy in Maryland

834,000Uninsured in Maryland

Estimate Based on Rise in UnemploymentNorth Carolina Institute of Medicine

www.whitehouse.gov accessed 3/21/ 2010

State Employee/Retiree Health Plan Expenditure2009 - $1.11 Billion 2010 - $1.15 Billion 2011 - $1.24 Billion

Total healthcare spending in Maryland State Budget: $9.9 Billion

Federal Medicaid Match (FMAP)American Recovery and Reinvestment Act (ARRA) raised the FMAP in Maryland from 50% to 62%. Increased funding runs out 12/31/2010. Maryland could lose $389 Million already budgeted for FY 2011.

Source: Maryland Health Benefit Plan Reports, 2010 (self-reported data submitted by health benefit plans to the Maryland Insurance Administration)

2008 2009 % Change

Individual 159,032 157,778 -0.8%

Small Group 440,730 409,810 -7.0%

Large Group 997,259 942,921 -5.4%

Total 1,597,021 1,510,509 -5.4%

Maryland’s Health Insurance Market

Transition and the Maryland Safety Net Prior to 2014

Maryland Health Insurance Plan (MHIP)• Insures 18,064; • Unaffordable for most• New Federal High Risk Pool- Maryland to receive $85 Million over 3.5 yrs; <10%

TheHealth Insurance Partnership• Small Group Market• Insures 1210 lives -currently• Firms participating in program declined 7% in 2009• Current State subsidies and New Federal Tax Credit• Dr. Rex Cowdry (MHCC) predicts tax credit will keep state program alive

Transition Period and the Maryland Safety Net (cont.);

New Regulations Patient Protection Affordable Care Act (PPACA)

• Dependent coverage to age 26 y/o Federal law, Current Maryland Law is 25y/o; will make a small difference• No lifetime limits, non-grandfathered plans• No pre-existing conditions, children only• PPACA: Medical Loss Ratios (MLR) increase 85% (large group market) and 80% (small group and individual market)• Current Maryland MLR standards 75% (small group market), 60% (individual market) and 85% for Managed Care Organizations (Medicaid MCO’s)

Transition and the Maryland Safety New Cont.

Maryland Medicaid Eligibility Currently 116% of FPL (Federal Poverty

Limit) for children, parents and caretakers;39% of FPL for others

Partial coverage under Primary Adult Care for non-parents to 116% FPL

Feds will allow early expansion of Medicaid to 133% FPL at FMAP of 50%. Can Maryland

afford it?

-38 CO-SPONSORS HOUSE OF DELEGATES

- 12 CO-SPONSORS SENATE

HGO VOTE: 7 FOR AND 16 AGAINST3 CO-SPONSORS AND 1 PUBLIC SUPPORTER VOTED AGAINST; VOTE COULD HAVE BEEN 11-12 AGAINST

FINANCE COMMITTEE: 3 FOR AND 8 AGAINST1 CO-SPONSOR VOTED AGAINST

MARYLAND HEALTH SECURITY ACT 2010(single-payer)

Maryland Economic Impact Study (EIS)

Physicians for a National Health Program (Maryland Chapter) is raising funds for a new study, to be done by the Lewin Group, comparing the economic impact of the Maryland Health Security Act to the current system post national reform. Tax deductible donations can be made online at PNHP Maryland (www.md.pnhp.org) or Healthcare Now Maryland (www.mdsinglepayer.org) websites. Checks can be made out to PNHP and mailed to PNHP c/o Eric Naumburg, M.D., 6163 Devon Drive, Columbia, MD 21044. For further information call Eric Naumburg at 443-562-6562

Healthcare-Now Maryland

A non-profit 501(c)4 group, formerly known as UHCAN, dedicated to single-payer, universal healthcare reform in Maryland. Website is www.mdsinglepayer.org. Listserve is the best source of information for single-payer events in Maryland. Recently affiliated with Healthcare-Now (national) for improved data base.

Local Groups in Howard County, Annapolis, Southern Maryland, Frederick, Montgomery County

Physicians for a National Health Program (PNHP)

A 501(c)3 non-profit national organization of doctors and providers dedicated to national universal single-payer healthcare reform. Great resource for research, expertise and analysis of current events related to single payer reform. Websites: www.pnhp.org and www.md.pnhp.org (Maryland branch)