The new law will create a box for people to check on state income tax returns. If a taxpayer checks the box, the state's health care exchange will see if the person qualifies, based on information in the tax return. Those who qualify for Medicaid will be enrolled automatically. The exchange will reach out to people who qualify for private coverage.
Hogan, a Republican, highlighted bipartisan work in the General Assembly, which is controlled by Democrats, on other health-related measures he signed Monday. One of them raises the smoking age from 18 to 21 and includes vaping in the definition of tobacco products.
"We are also proud to continue Maryland's record of leadership on health care by enacting legislation to further improve access and lower costs," Hogan said. Sen. Brian Feldman, a Democrat, said the measure is part of a response to efforts at the federal level to overturn the Affordable Care Act, including the end of the mandate requiring people to have insurance or else pay a tax penalty.
The Maryland measure initially included a provision that would have revived the individual mandate in Maryland, but with an innovative twist: the uninsured would have had a choice of paying a tax penalty or make a down payment on health insurance. That provision was taken out of the bill.
"We've been continuing to look for bipartisan ways to get more Marylanders health insurance," Feldman said. "We've made a lot of strides. About six or seven years ago, we had about 760,000 people without health insurance. Now, we're down to 360,000, and in light of what's happening at the federal level — the dismantling of the Affordable Care Act, the elimination of the mandate, we're starting to see some backtracking on that. So, we came up with an idea here that's first in the nation that you can use the state income tax return to check a box, and it will immediately opt in."
Stan Dorn, who is director of the National Center for Coverage Innovation, estimated there are tens of thousands of Maryland residents who do not have health insurance who are eligible for low-cost insurance but don't know it.
"The problem of millions of Americans being uninsured but eligible for help has escaped notice, and today Democrats and Republicans in Maryland have come together to find practical innovative solutions to help lower people's health care cost and get more people the financial security that comes with health insurance," said Dorn.
Dorn said he hopes to spark interest in other states in the idea. "We haven't begun beating the drum, and we've already heard from Oregon, New Mexico and Virginia," Dorn said. "I'm expecting we're going to hear from state capitals all around the country, interested in following up with what's happened here."