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Caring for the uninsured

June 06, 2003

Maryland Health Secretary Nelson Sabatini this week proposed a new plan to cover more citizens who can't afford health insurance. As we said the last time something like this was talked about, any new plan must be carefully crafted to keep the state from becoming a magnet for indigent persons with chronic conditions.

That may sound cruel, but just as it's fiscally impossible for Washington County to provide all the rehabilitation services needed by inmates released from the three local state prisons, Maryland cannot afford to take on the health-care burdens not shouldered by Pennsylvania and West Virginia.

Secretary Sabatini is at least savvy enough to know that this is not the time to launch such a program, given Gov. Robert Ehrlich's desire to reduce the regulatory burdens on the state's businesses.

Its details come in part from a plan former House Speaker Cas Taylor released just days before his defeat last November. Taylor proposed expanding eligibility for Medicaid services and creating a health insurance purchasing pool for uninsured citizens.

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Taylor did not specify how all that would be funded, except by cuts in unspecified programs and by eliminating those much-talked-about but hard-to-find villains, waste and inefficiency. Sabatini wants to employ tax credits to help employers pay for workers' basic health plans.

Vincent DeMarco, director of the Maryland Citizens Health Initiative, says that approach won't work. He prefers to raise cigarette taxes again and charge fees for employees who don't offer health coverage.

But unless this is done on a regional basis, those employers who can leave the state will do so and those who might consider coming to Maryland will have a new reason to avoid it.

The answer is not a one-state approach, but a regional or national one that controls costs. That way, employers would know with some reasonable certainty what their costs will be from year to year and citizens would know that they'd be covered even if they changed jobs.

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