2020 Legislative Session
In 2020, the Legislative Session ended early due to the Coronavirus Pandemic, so we did not get as much accomplished as we would have liked. The Governor did allow one of our priority bills HB 959/SB 872 - Health Insurance - Consumer Protections to go into effect without his signature, a measure to write the consumer protection provisions of the federal Patient Protection and Affordable Care Act (ACA) into Maryland law and allow the Insurance Commissioner to enforce them. The Legislature did pass HB 1095/SB 669, which would have established a permanent funding source for the Prescription Drug Affordability Board, which was created in 2019 to help make all drugs, including brand name and specialty drugs more affordable. The Board looks at high cost prescription drugs and determine fair appropriate rates, and begin to establish upper limits for state and local government entities to pay (pending approval of the Legislative Policy Committee.) So people don ’t have to choose between getting well or getting lunch. However, it was vetoed by the Governor.
HB 1095/SB 669 - Prescription Drug Affordability Board and Fund: Establish a permanent funding mechanism to the Prescription Drug Affordability Board (see below). This is necessary to prevent threats to the Board doing its work such as happened in 2019. The General Assembly designated approximately $800,000 to fully support the Board and its activities; before establishing a revenue source, but the Governor did not release the funding. This legislation will also accelerate the Board's plans to institute an assessment on pharmaceutical manufacturers and supply chain members beginning in 2020.
HB 959/SB 872 - Health Insurance - Consumer Protections: Establishes the consumer protection provisions of the federal Patient Protection and Affordable Care Act (ACA) that are currently specified through cross-references in Maryland law. It also establishes nondiscrimination provisions. The bill generally applies to any health benefit plan offered in the small group, individual, or large group markets and specifies exceptions for grandfathered plans. The Insurance Commissioner is authorized to enforce these provisions and must adopt specified regulations.
Small Business Health Option Plan: Expand health care coverage by helping small businesses provide health care for their employees. Providing incentives for small employers to offer health insurance under the Small Business Health Option Program (SHOP) could increase the number of employees covered from the low rate of 27.7% Investing additional funds for tax credits would encourage employers to participate in SHOP. Investing in marketing and administering SHOP would help employers learn about the program and increase participation in it. Simplifying the small business tax formula would reduce one of the barriers that discourages employers from participating in the program.
2019 Legislative Session
Protecting the Affordable Care Act
GOAL: Passage of the Health Insurance Down Payment Proposal. This proposal would replace the Patient Protection and Affordable Care Act (ACA’s) individual mandate eliminated in the recent federal tax reform legislation with a Maryland health insurance down payment plan. The federal individual mandate was a program that charged fines for individuals if they were not enrolled in a qualified health insurance plan. The Health Insurance Down Payment Proposal would allow a tax payer who is faced with a fine for not having qualifying coverage at tax time to have the option for this fine to go toward their health insurance in the Maryland Health Exchange. The work of UULM-MD will be in conjunction with Health Care for All and Consumer Health First as we are members of these coalitions. Senator Brian Feldman and Delegate Joseline Pena-Melnyk are the lead sponsors.
WHY: This is Maryland’s innovative response to federal attempts to roll back the ACA by ending the enforcement of the ACA’s individual mandate. This proposed legislation would replace the expiring federal mandate with down payments to help the uninsured get coverage while lowering costs of individuals that buy their own insurance. Doing this would increase the number of younger and healthier people in the insurance pool and allow for them to obtain federal subsidies if their jobs do not provide insurance or their incomes are not adequate to purchase insurance.
Maryland decreased the number of uninsured to 6.6% in 2015 from 11.3% after the ACA was implemented in 2013. However, there are still thousands of Marylanders eligible for the ACA who have not been enrolled. It is necessary to maintain those now covered by the ACA and increase the numbers. If this legislation is not passed, this will not be feasible as rates will increase and it will be harder to maintain and expand those insured.
Prescription Drug Affordability Board Act
UULM-MD also supported the proposed Prescription Drug Affordability Initiative to help make all drugs, including brand name and specialty drugs more affordable.
Marylanders across the state are struggling to afford the prescription drugs they need, often having to choose between their medication and other necessities, like rent and groceries. As prescription drug costs continue to soar, it is critical that the Maryland General Assembly take action to help ensure that all Marylanders have access to affordable medications, because drugs don’t work if people can’t afford them.
What can Maryland do? Maryland can create a Prescription Drug Affordability Board, an independent body with the authority to evaluate high cost drugs and set reasonable rates for Marylanders to pay. The Prescription Drug Affordability Board will look at prescription drugs with costs that greatly impact Marylanders, including high-cost, brand name medications. High costs can prevent Maryland patients from accessing the prescription drugs they need, cause significant affordability issues for the state, and threaten public health.
How a Prescription Drug Affordability Board works: The Board is composed of five members (plus a Stakeholder Council and staffing support) appointed by the following:
• one member by the Governor,
• one by the Senate President,
• one by the Speaker of the House,
• one by the Attorney General, and
• the Board Chair to be jointly appointed by the President and Speaker.
The Board will review prescription drugs that meet any of the following criteria:
• New brand name prescription drugs which enter the market at $30,000 or more per year or course of treatment;
• Existing brand name medications which increase in price by $3,000 or more per year or course of treatment;
• Generic medications which increase in price by $300 or more per year or course of treatment; and
• Any prescription drug that creates affordability challenges to the Maryland health care system, including patients.
The Board will consider a broad range of economic factors when setting appropriate payment rates for reviewed drugs, allowing pharmaceutical manufacturers the opportunity to justify existing drug costs. Once a fair payment rate is determined, the Board sets an upper payment limit that applies to all purchasers and payer reimbursements in Maryland, ensuring that lower costs benefit consumers.
At the end of the session, both major bills had been heavily amended and passed.
HB 697/SB 868 - Health Insurance - Consumer Protections and Maryland Health Insurance Coverage Protection Commission – Passed and Signed by Governor
HB 814/SB 802 - Maryland Easy Enrollment Health Insurance Program – Passed and Signed by Governor
HB 768 - Health - Prescription Drug Affordability Board – Passed and Governor is allowing to become law without his signature
FOR MORE INFORMATION:
Health Care for All! Coalition (MD) healthcareforall.com– Information on legislation to improve health care--UULM-MD is a coalition member.
Consumer Health First http://www.consumerhealthfirst.org -- information about MD Health Connection and ACA; formerly the Maryland Women's Coalition for Health Care Reform; UULM-MD is a coalition member.
Maryland Health Connection marylandhealthconnection.gov or call the Consumer Support Center, 1-855-642-8572 for information and to sign-up
Kaiser Family Foundation ACA info for consumers - http://kff.org/aca-consumer-resources