How Health Care Affects Marylanders

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Quaker Quill: The State of Health Care in Maryland
What will American health care look like four years from now? On the campaign trail Donald Trump made several promises regarding health insurance in our country. At a debate on Fox News in October, Trump pledged to “repeal and replace the disaster known as Obamacare,” saying that the Affordable Care Act (ACA) is “destroying our country [and] destroying our businesses.”
He repeated this message at nearly all of his campaign stops, and the American people ate it up. Many believe that Obamacare creates high premiums, is unconstitutional, and constitutes an intrusion into the dealings of private businesses and individuals. The popular disdain for the current system is unarguable, but what is it these citizens want? What will healthcare look like in Trump’s America? Will he provide a viable alternative to the ACA? The United States is one of the only industrialized nations that still does not provide universal health care for its citizens. Trump vowed in an interview in early January that his replacement plan would provide “insurance for everybody.” Yet according to the Washington post, at least 18 million people would lose health insurance in the first year if Republicans move ahead with plans to do away with major sections of the Affordable Care Act without a detailed, practical replacement plan.

On, Trump released a seven-point plan for healthcare reform, which he described as based on “free market principles.” He stated that he would repeal Obamacare, reduce barriers to the interstate sale of health insurance, institute a full tax deduction for insurance premium payments for individuals, make Health Saving Accounts inheritable, require price transparency, block-grant Medicaid to the states, and allow for more overseas drug providers through lowered regulatory barriers. He added that enforcing immigration laws could reduce healthcare costs in the long run.

Some health care professionals are very concerned about Trump’s points. Even just one of these proposals — say the Medicaid block grants — would profoundly change the way health care operates in Baltimore. Mary Miller, Chief Financial Officer of Mt. Washington Pediatric Hospital, oversees the patient accounting department, where insurance is billed for all the hospital’s services. She expressed her concerns about Trump’s proposed block grants in a recent phone interview.

Miller explained that the situation for patients in Maryland is very different than in other states, saying that “even before Obamacare, Maryland generously covered children under Medicaid, so the only patients we would see who are affected by Obamacare are those whose families didn’t have insurance before. But Maryland has always had really good coverage for people, so we don’t see as many newly insured patients as in other states.”

Still, Miller predicts that “huge changes” will ensue for some Maryland patients under the new administration as a result of significant, structural changes proposed for the Medicaid program. “They’re thinking of making it a block grant program as opposed to an entitlement [program]. Entitlement means that if the population that is entitled [to insurance] grows, the amount of money has to grow. So in bad economic times, Medicaid costs grow. If healthcare treatments become more expensive, Medicaid costs grow.”

“If they change it to a block grant program,” she continued, “that means they would give Maryland a capped number of dollars, and it wouldn’t matter if we had lots more families who needed it. It wouldn’t matter if, y’know, cancer drugs got much more expensive, you would just have to make do with that amount of money. That could have a huge impact on the Medicaid population in Maryland, and for us at Mt. Washington, that’s many of our patients.”

Trump has yet to make specifics about the block grant available, but it was explicitly mentioned in his seven-point plan. This change to the way Medicaid is funded could be disastrous for those insured in Maryland. We can only hope that his other proposed initiatives will make American health care more inclusive and available.

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