Exhaustion Begats Success
The special session is over, and the Thanksgiving break has given me much-needed physical and emotional separation from Annapolis, the State House, and the political process.
Last Monday morning when I rolled through the door in Brunswick at 3 A.M., I felt completely broken, physically, mentally and spiritually. The policy battles over the budget, taxes, and slot machines took a significant toll, more than anything else I had ever done in six years of state legislative service.
You know by now that I broke ranks with the Republican Caucus in the House to vote in favor of the slot machine referendum. That decision, based in large part on what I perceived at the time to be Frederick Countyís best interests, seems to have broad repercussions that may not be fully realized until the 2010 elections.
One interesting observation: By the time we go to the polls to vote on delegates and senators in 2010, we will have already voted on slots, each one of us. Thatís right; you voters will have the chance to do what the state legislature has failed to do for five years. Youíll get to weigh in on whether we should allow slot machine gaming in Maryland. Frankly, I have a lot more faith in your ability to make that choice than I do the legislature!
Iíll be dealing with rancor within the state Republican Party for some time. They believe, and have convinced others, that by defeating the slots referendum, the special session would have ended without the tax increases passing. They donít seem willing to embrace the idea that even though five Republicans voted to allow slots to go to referendum, every single one of us voted against the sales, income, and corporate tax increases passed in the bloodlust to raid the wallets of Maryland citizens.
You donít read it in the newspapers, but the GOP Caucus in the House and Senate were batting 1000% fighting the tax increases. All 37 GOP delegates and 14 senators stood together in suggesting a better way to balance Marylandís budget.
Gov. Martin OíMalley is quoted as having said this special session was a bi-partisan effort. Maybe on taking slots to referendum, but he clearly cannot lay legitimate claim to bi-partisanship on the tax increases, try as he might. That necklace gets hung around the Democratic Party all alone. I think they deserve the full and unmolested credit for that!
No matter how often I argue that this perspective about killing the slots referendum just isnít true, some refuse to let go of the dream. Those same people are the ones who call conservative talk radio, write editorial letters, and compose nasty emails. So be it.
Iíve had very personal and fruitful discussions with my own House Republican Caucus leadership in the last few days. I think I understand their perspective, and I know they understand mine. As far as the state party goes, Iím just not going to worry about it. They can say what they think they need to say, Iíll do the same. Iím very comfortable in letting District 3-B voters decide my effectiveness.
Speaking of that, this whole special session wasnít a bust from a policy standpoint. After three years of struggling to find a way to bring the working poor into the realm of health insurance coverage, I helped ďgit 'er done.Ē
The bills, House and Senate Bill 6, extends coverage to approximately 120,000 Marylanders who do not currently have a health plan. Weíve lowered the threshold to 116% (a family making less than $25K) of the federal poverty level, so folks working part time can now qualify under the Maryland Health Insurance Plan for the subsidized basic HMO plan.
Also, small employers who employ between two and nine workers are eligible for a $1,000 subsidy toward the cost of a qualifying health insurance premium for those workers. That $1,000 could be enough to convince the owner of a small company to bite the bullet and offer a health plan.
If youíve followed my legislative career (such as it is), then youíll know that relative caregivers are a particular passion. Iím really proud to say that the bill also includes relative caregivers in the expansion provisions, so many of the most loving and caring people (but far from the wealthiest) Iíve ever met will now qualify for lower cost health insurance for themselves and the children they care for.
The naysayers point to the expansion of our state Medicaid program; and this act does constitute a significant expansion. They also use the artful dodge that this is a move toward socialized medicine. As is usually the case, the best defense against an empty policy argument designed to choir-preach is to employ that most powerful political tool Ė the truth.
Weíve been complaining for years about uncompensated care. Hospitals treat poor sick people, as required by federal law. While the hospitals do write-off large amounts of uncollectible debt, they also seek reimbursement for care rendered to people with no ability to pay. We each pay about a $1,000 per year in our health premiums into a pool for this hospital reimbursement program.
Getting more people covered by health insurance lets us reduce this uncompensated care burden. As the demand drops, this act takes increasing amounts of money from this pool to cover the insurance costs. Also, if voters approve the slots referendum, then some of the General Fund previously used for other purposes will be redirected into the insurance subsidy. The rest of the drop in uncompensated care will be returned to you, the people who have been paying into the fund for years.
Getting more poor sick people health insurance will also reduce wait times in our hospital emergency rooms. Studies prove conclusively that when they can access affordable preventative care, poor people will use a family doctor instead of visiting the local ER for their primary care. Without insurance, this isnít even a choice.
To the conservatives who argue for a private market-based health insurance solution (no subsidy), you should be aware of the testimony of the largest insurers in Maryland, CareFirst and United Healthcare. Both testified that there will never be a private market solution for the working poor, that the only way to solve this problem is with a public/private sector solution that includes some form of subsidy.
Donít fall for the conventional wisdom that suggests that nothing important happened over the three weeks in Annapolis. Sure, weíre all about to feel the burden of taxation sought by the governor as a way to balance the budget. But each of you will be given the opportunity to cast a vote on whether you believe we should expand revenue to the tune of $400-$500 million dollars a year through slot machine gambling.
Finally, weíve taken a step towards reducing wait times in our hospital emergency rooms and bringing down the overall costs of health care in Maryland by expanding the rolls of the insured.
Now thatís an outcome I can be proud of.