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Gov. Martin O'Malley Headshot

Affordable Care Act

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As Governor, I hear the heartache of parents wondering whether they can afford essential medical care for themselves or their children. I watch rising health costs erode the competitiveness of innovative companies and small businesses. And I know that political posturing about the Affordable Care Act is not an approach that will address these problems and move our state forward.

With public and private innovation, Maryland is implementing the Affordable Care Act to strengthen coverage, improve health, and support our competitiveness in the global economy. As we have rolled up our sleeves to get to work in Maryland, others have decided to play politics with the Affordable Care Act. Accusations that the law will doom state budgets or nationalize the health care system are simply false and leaders who choose posturing over performance today will have some tough questions to answer down the road from families and businesses alike.

One day after President Obama signed the Act into law, I created a Health Reform Council to travel the state and hear ideas for implementation in Maryland. The Council held more than 35 public meetings and received hundreds of comments.

As part of this process, an independent team from the University of Maryland assessed the likely impact of the Affordable Care Act in our state. Their analysis projected that implementation will help several hundred thousand Maryland families afford private insurance coverage. It will also reduce the burden of uncompensated care throughout our health care system, save our Medicaid program millions, support small businesses through significant tax credits, close the donut hole for our seniors, and help our young people stay on their parents' coverage.

The University of Maryland experts estimated that health reform will provide a net savings to our state budget of more than $850 million by the year 2020. To capture these savings, we will need to implement the law with an eye to Maryland's unique circumstances. Fortunately, rather than a "one-size-fits-all" approach, the law provides a powerful set of tools for states to use and adapt.

For example, Maryland has a successful small employer market for health insurance. This market now covers nearly 400,000 employees working in 47,000 businesses. Our decisions about how to structure the insurance exchange for small businesses under the Affordable Care Act will be guided by our interest in building upon this market.

Maryland is the only state in the country that sets hospital rates so that all payers, public and private, pay the same fees at the same hospital. The rate setting commission determines the rates at each hospital based on how much uncompensated care the hospital provides, the local labor market, and other factors. This successful "all-payer" approach allows the state to create incentives through rates for cost savings, rather than cost shifting. It is an important reason why Maryland has experienced the lowest rate of growth in hospital expenses of any state over the last several decades.

The Affordable Care Act will also support Maryland's expanding health information technology infrastructure, which will include dozens of hospitals and hundreds of practices. It will support our state's commitment to primary care through support of the medical home model and loan repayment for health care providers. The law further provides great flexibility to help us redesign access to Medicaid and other public health programs, reducing bureaucracy and costs.

In Maryland, instead of playing politics, we will use the many tools in the law to improve public health and stop the train of runaway costs barreling down on our children's future and we will measure success by the numbers -- how many families no longer have to choose between health care and bankruptcy; how few people are denied coverage when they need it most; and how many more companies are able to provide health insurance and reinvest savings into their workforce to create jobs.