ANNAPOLIS – Maryland state lawmakers and health care advocates announced a plan on Jan. 9 to continue the health care individual mandate in the state.
The individual mandate was a provision in the Affordable Care Act that required individuals to enroll in health insurance or pay a penalty, unless they qualified for an exemption.
The tax bill Congress passed in December eliminated the individual mandate starting in 2019’s tax season. Now this state proposal could bring it back for Marylanders in 2020.
“The gutting of the individual mandate is a serious problem for keeping the Affordable Care Act alive and working,” said Vinny DeMarco, president of the Maryland Health Care for All Coalition.
State lawmakers hope to create a plan that will use the individual mandate as a “down payment” on health insurance. That means the money people would have to pay for not having healthcare would go toward buying an insurance plan unless they chose for it to go to the state treasury.
If they are not able to enroll with zero additional cost to that payment, the money would be placed in an escrow account.
Then, when the next open enrollment period begins, Maryland Health Connection would help them assess the insurance options the consumer could purchase with additional cost.
If they do not use the “down payment” by the end of open enrollment, the money would go into a health insurance stabilization fund.
Stan Dorn, a senior fellow with Families USA, said more than 60,000 uninsured Marylanders would have access to a health care plan at zero additional cost and over 200,000 people could benefit from the plan.
“The result will be that young and healthy adults will, in fact, step forward and get coverage, the risk pool in this state will improve, and premiums will come down for all Marylanders who get their own insurance,” Dorn said.
The down payment would equal the federal penalty for the health care individual mandate.
In 2017, the penalty was $695 for each person ($347.50 for children) on the tax return without health insurance or 2.5 percent of the household’s income, whichever is greater.
Maryland is the first state in the nation to propose such a plan.
State Sen. Brian Feldman (D-15) said he hopes the plan will stabilize Maryland’s insurance market.
Last year, a representative from CareFirst told the Maryland Health Insurance Coverage Protection Commission that due to uncertainties regarding the Affordable Care Act (ACA), young and healthy people were leaving the insurance market.
“You need them in insurance pool,” Feldman said. “Over time, what we’ve been left with and has resulted in massive insurance premium increases is an older, sicker population in our insurance pool.”
He said the representative informed the commission “that if we do nothing in the 2018 session, that he thought our individual insurance market in the state of Maryland could collapse in 2019.
“(That’s) very scary. Doing nothing is not an option. No action is not an option. We’ve got to move forward to stabilize our insurance market.”
Feldman expects this proposal will be an opportunity for bipartisan collaboration.
“I’m really optimistic we can get something bipartisan done,” he said. “The stakes are high, and there’s really no reason this should be a partisan, political issue, healthcare shouldn’t be a partisan, political issue.”
Supporters of the plan hope Gov. Larry Hogan will welcome it. In July, he signed a bipartisan letter to U.S. Senate leaders in opposition to their proposed “skinny repeal” of the Affordable Care Act.
Among other ramifications, that repeal would have eliminated the individual mandate.
“The governor obviously, I think through that letter expressed indication that getting rid of the mandate was not a good idea,” Feldman said.
DeMarco said as of Jan. 15, the bill had not yet received support from Republican lawmakers.
“It is very, very important that this session, Maryland enact the health insurance down payment proposal, and that that will, we hope to be a model for the nation,” DeMarco said.