Current Status of Health Care Insurance Coverage in Maryland

MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE

FY2002 STATE PLANNING GRANT APPLICATION

SUBMITTED TO

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

HEALTH RESOURCES AND SERVICES ADMINISTRATION

APRIL 4, 2002

PROJECT ABSTRACT

Current Status of Health Care Insurance Coverage in Maryland

Maryland's uninsured rate of 12% (1999 and 2000 Current Population Survey [CPS]) for the non-elderly is well below the comparable national figure of 16%. The average uninsured rate for all Maryland residents in 1999-2000 was 10.4%. Maryland ranks in the top 15% of all states in terms of its low rate of uninsurance. The state's lower rate of uninsured is principally due to higher levels of workplace-provided coverage.

In Maryland, as compared to the U.S. as a whole, both a higher percentage of private firms offer health insurance to their employees, and a larger share of workers are employed in the public sector, making well-subsidized health care coverage available to nearly all Maryland employees. As a result, considerably more of Maryland's residents are covered primarily by employer-based insurance than in the U.S. as a whole. Moreover, because Maryland's poverty rate is among the nation's lowest, the portion of residents covered by Medicaid is below the nationwide rate.

Maryland's Earlier Efforts to Expand Access to Health Coverage

Maryland has employed a number of different strategies in both the private and public sectors to ensure that residents have access to health insurance coverage. In general, three types of strategies have been utilized:

• Publicly funded, comprehensive health insurance coverage programs: Medicaid; HealthChoice, the state's Medicaid managed care 1115 waiver program; Maryland's S-CHIP programs, Maryland Children's Health Program (MCHP) and MCHP Premium, the latter of which features an option to provide coverage through employer-sponsored insurance; the State Omnibus Budget Reconciliation Act (SOBRA) and S-CHIP Medicaid coverage expansions for pregnant women;

• State-sponsored initiatives to increase private sector health insurance coverage: The 1993 small group market reform effort; the Substantial, Available and Affordable Coverage (SAAC) program for the medically uninsurable, which is aimed at the individual insurance market; and the state's all-payer hospital rate-setting program; and

• Publicly funded supplemental health care and medical services programs, which strive to fill gaps in existing