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Care for Maryland's indigent

January 04, 2007

As Hagerstown's Community Free Clinic struggles to find funds to care for its many needy patients, it's good to hear that Maryland's legislature is working on a plan to cover more of the state's uninsured.

How many people are we talking about? The Associated Press reports that the latest U.S. Census estimate puts that figure at 780,000.

It also notes than the cost of uncompensated hospital care rose 27 percent in the last fiscal year, to a total of $738 million.

So what's the solution?

The group, which includes a House of Delegates health committee, a joint legislative task force, the Maryland Health Care for All Coalition and the Greater Baltimore Committee, agrees that the state's Medicaid program must be expanded, at a cost of at least $200 million.

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The proposed legislation would also help small businesses with health care for their employees and mandate that high-income individuals purchase health insurance.

That last feature is borrowed from a 2005 Massachusetts law that requires all adults to have health insurance.

The first big question is: How will it be paid for? One option is to increase cigarette taxes again, to $2 per pack.

But every tax increase inspires more smokers to quit, so eventually another funding source would be needed.

Our second question: What residency requirements will apply to those getting state aid? If Maryland's health-care program is significantly better than those of surrounding states, an influx of indigent patients could quickly invalidate that $200 million estimate.

Once the states demonstrate that universal care is possible, the federal government should take the best of their ideas and run with them nationwide.

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