As Gov. Martin O?Malley and lawmakers look ahead at funding new programs in future years, health care spending for the poor and health insurance for employees and retirees is consuming an increasing chunk of the budget, with no relief in sight.
In O?Malley?s proposed fiscal 2008 budget, for instance, the Medicaid health insurance program for the poor and disabled takes up 18 cents of every dollar. This year, 643,000 people ? 11 percent of the state population ? get their health insurance this way.
O?Malley wants to cover more children under Medicaid. According to legislative analysts, children make up about two-thirds of Medicaid recipients, but they account only for 20 percent of the costs of the program. The governor also wants to increase payments to doctors and nursing homes, which have borne the brunt of cost-containment measures.
House Speaker Michael Busch and other lawmakers want more of the “working” poor to be eligible for the program to cut the number of people who are uninsured, also a goal of those favoring a $1-a-pack cigarette increase to pay for it.
“Expanding health care coverage is a complex, intertwined and costly problem,” O?Malley said in a statement.
Even before coverage is expanded, Medicaid and related health programs cost the state $5.2 billion a year, with the federal government matching most of the state contribution. Those costs are going up 8 percent a year. Revenues to pay for it are only rising 5 percent a year. This is part of what is called the “structural deficit.”
“Medicaid is going to continue to eat up a larger share of the state budget over time,” said David Romans, a budget analyst for the legislature. “Clearly long-term care is where were spending a lot of the money.”
Medicaid recipients receiving nursing home care make up only 5 percent of the enrollees, but they consume 30 percent of the budget, Romans said.
