Health Care News, Heartland Institute (Chicago, IL), July 1, 2008

As many as 90,000 eligible children in Maryland are not enrolled in the state's subsidized health insurance program, according to state estimates, despite several expensive and lengthy marketing campaigns commissioned by the state government.

This element of the uninsured population has now been targeted by another piece of legislation, the Kids First Act (HB 1391), signed into law by Gov. Martin O'Malley (D) on May 22.


'Cranking Out Paper'

The goal of HB 1391 is to encourage more working-poor families to enroll their children in the state's low-income health insurance programs. It requires the state comptroller to send to taxpayers with dependent children, and whose reported income does not exceed the eligibility standard, notices of eligibility to enroll in either the Maryland Medical Assistance Program or the Maryland Children's Health Program.

The contents of the notices are to be determined by the Department of Health and Mental Hygiene.

The Kids First Act does not include enforcement measures. Legislators decided not to implement an individual mandate, instead requiring the government to send notices of eligibility for what are essentially optional programs.

Analysts such as John R. Graham, director of health care studies at the Pacific Research Institute in San Francisco, have criticized the development. Graham said, "It has no implications, other than a few more public servants will be employed cranking out paper for the welfare state."


'Waste of Time, Money'

Beginning in 2009, Maryland state income tax forms will have a place designated for taxpayers to indicate whether their dependents are enrolled in health coverage programs. Families whose income and insurance status qualifies for government assistance will receive an enrollment application and literature about the program in the mail within weeks of filing their taxes.

The bill's sponsor, state Rep. Heather R. Mizeur (D-Montgomery), said HB 1391 serves to "break down a barrier" and put insurance applications "in the hands of a family."

"It is a waste of time and taxpayers' money sending out another piece of paper that they will ignore," countered Graham. He added, "Families do not enroll their kids in government health plans because they do not have to until they need medical services. Sending them another notice from the government will not change that.

"I would recommend that Maryland stop providing a government-run health plan for low-income residents and [instead] use that money to fund tax credits or vouchers that families can use to buy portable health insurance that they can keep for the long term, rather than falling in and out of Medicaid and employer-sponsored health care," Graham concluded.

Dr. Sanjit Bagchi (drsanjitbagchi@gmail.com) writes from India.

For more information ...

Maryland House Bill 1391, the "Kids First Act": http://mlis.state.md.us/2008rs/billfile/hb1391.htm