News from Annapolis and Beyond

Crossover Day, Monday, March 18, is fast approaching. That is the day when bills move from one side of the street to the other and we begin to get some clarity on which ones have a chance of making it to the Governor's desk. You can learn more about the bills we support (and oppose) and find our testimony  here.

Here are a few of this week's highlights:  
  • At Tuesday's Health and Government Operations Insurance and Pharmaceuticals Subcommittee meeting, the following bills were discussed:
    • HB599 - CHF strongly supports this bill which will require routine reporting by insurance carriers on their compliance with the Mental Health Parity and Addiction Equity Act. Proponents of the bill had proposed an amendment to require carriers to include a notice about consumers' rights to an appeals process for denied mental health and substance use services. We believe such a notice would be helpful, but the bill moved through without that amendment. There will be further discussions on this and other parity issues in the interim.
    • HB697- An amended version of this bill was approved by the subcommittee. It provides for a work group under the Health Insurance Coverage Protection Commission to "determine the most effective manner of ensuring that Maryland consumers can obtain and retain quality health insurance independent of any action or inaction on the part of the federal government ... " A report is due to the Commission on or before December 31, 2019.  
    • HB814- Otherwise known as the "Down Payment Bill." the subcommittee approved amendments to eliminate the individual responsibility (mandate) provision for health insurance but retain the question on a new state income tax form as to whether individuals have health insurance. Those who indicate they do not have health insurance and qualify for Medicaid will be auto-enrolled in the program. All others may authorize the Maryland Health Benefits Exchange to contact them to give them more information about coverage options and, if the individual decides to enroll in a health plan, help them do so during a special enrollment period. The amendments offer an innovative way for individuals to learn more about health care coverage options but falls short of incentivizing all uninsured individuals to purchase coverage, a step we feel is needed to bring healthier individuals into the individual market.
  • On Wednesday, we testified in support of two bills in the Senate Finance Committee that have already been heard on the House side. These include: 
    • SB 761 - Payments to Noncontracting Specialists and Nonpracticing Nonphysician Specialists 
    • SB868 - Consumer Protections - This is the companion bill to HB697 above, that was amended on the HGO subcommittee. 
  • Today, we will testify in Health and Government Operations Committee on the following: 
    • HB 378 - We support this bill, State Provided Health Care Benefits, which provides for a version of a public insurance option in Maryland that aligns with proposals, of which CHF has been supportive. 
    • HB 806 -  As we did last year, we oppose this bill to submit what is known as a 1332 waiver that would allow the sale of "Copper Plans." Health policy experts have emphasized that such plans, might have lower premiums, but the high deductibles and out of pocket costs, could be ruinous if individuals actually require health care services. In addition, because the state is looking broadly at affordability issues we do not believe that now is the time to introduce such plans in our individual market.
The President's Budget Proposal: 
Bad for the Health of America

On Monday, President Trump sent to Congress his   "A Budget for a Better America" with the subtitle "Promises Kept. Taxpayers First." Not only does it not adhere to his promise that no changes would be made to Medicaid or Medicare, but it clearly doesn't align with our concept of health care for all. In fact, the proposals would reverse the progress we have made in spite of the Administration's "death by a thousand cuts" approach.

Here are the highlights:
  • $845 billion dollars cut from Medicare over the next 10 years just as baby boomers start to flood the program.
  • $245 billion cut from Medicaid over the next 10 years to "shift more power to the states."
  • A nationwide work requirement for Medicaid.
  • The elimination of "zero premium" ACA plans.
  • 12% decrease in funding to the NIH, amounting to about $4.5 billion.
  • 10% decrease in funding to the CDC, despite a year in which outbreaks of measles, whooping cough, flu, and other diseases normally protected by vaccines, are on the rise.
Add to this the cuts made to the EPA and its environmental health programs, as well as global health programs, humanitarian aid, and more. Taken together, this becomes an all out assault on the health and well being not only of Americans, but our friends around the world. 

See where your elected officials stand:
  • Congressman Andy Harris of the 1st District has not issued a statement, however, here is what others in Maryland's Congressional Delegation are saying: 
See what the media and others are saying: 
And as if that weren't news enough:
  • First, the good news: 
    • HB 1272 / SB904 currently in the General Assembly -
      is designed to combat the new "Gag Rule" issued by the Whitehouse, which prohibits federal funding of family planning programs, by requiring the Governor to fund Maryland's Family Planning Program regardless of actions taken at the federal level. We support the legislation and you can read our testimony here.
  • Now the not so good news:
      • New "Gag Rule" affecting Title X would hurt millions - states the Editorial Board of the Washington Post. The American Medical Association and Planned Parenthood, along with 21 state attorneys general (including Maryland), filed lawsuits last week arguing the "gag rule" would undermine the medical relationship between a woman and her doctor. Planned Parenthood President Leana Wen stated, "Imagine if the Trump administration prevented doctors from talking to our patients with diabetes about insulin. It would never happen. Reproductive health care should be no different."
      • Tricia Brooks, in a blog for the Georgetown University Health Policy Institute, demonstrates that under President Trump, children's enrollment in Medicaid/CHIP has lost its momentum. Fortunately, in Maryland we have mostly made advances. But, that doesn't lessen our concern over what is happening in other states. We believe that every child is "our" child and they deserve the health care that will allow them to lead productive and happy lives.
      • How Does Losing Medicaid Help You Find a Job? - it doesn't. That's the clear outcome from research, as well as the disastrous real life experience playing out in Arkansas. The Nation, looks at Arkansas, as well as other Medicaid Expansion states like Ohio, Michigan, and Montana, where enrollees were better able to work once they had coverage; losing coverage, didn't lead to any gains in employment.
      • Social media as a tool to catch "welfare cheaters." For those individuals receiving federal disability funds, be careful about what you post on social media, says the New York Times. Social Security has said it would study whether to expand the use of social media networks in disability determinations as a way to "increase program integrity and expedite the identification of fraud." In other words, don't post a picture of yourself dancing, if you're generally confined to a wheelchair. We don't believe anyone should "cheat" to get benefits, but we question the motives of this Administration in the aggressive approaches they are taking and the impact that could have on those who rightly deserve support.
      • Buyer Beware - "Cheaper" healthcare policies, as much as 15%-30% cheaper, can now be purchased off-exchange from brokers in some states. However, consumers need to be savvy enough to shop around for providers who will accept that lower reimbursement. Consumers who don't shop - or can't because their medical need is urgent - risk getting "balance-billed" by providers who are unsatisfied with the flat amount the plan pays. Balance bill amounts range widely, but could be thousands of dollars in the case of hospital care, and are not capped by the ACA.
  • Job Posting
    • The Maryland Community Health Resources Commission is seeking to hire a full-time Special Assistant to the Executive Director. Applications are due no later than 11:59 pm, Friday, March 22 2019. For more information or to apply for the position, click here:
    Once again, even as we have spent the last 2 months in Annapolis trying to ward off threats to Marylanders' access to health care and core consumer protections, the federal government has now issued even more threats to America's health care system by threatening funding and coverage. This is frustrating to say the least ...and also costly to protect. To maintain this effort we need your help. Please show your support for this important work and donate today.


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