The Affordable Care Act, which became law in 2010, was a landmark moment in the quest to ensure access to health care for all Americans, expanding health coverage to more than 400,000 Marylanders, which reduced our uninsured rate from 12% to 6%.

But the work did not end with ACA passage, and Maryland has subsequently taken a series of important steps to strengthen our health care system. A key moment came in 2019, when the Maryland General Assembly passed two measures sponsored by Del. Joseline Peña-Melnyk and Sens. Kathy Klausmeier and Brian Feldman that are transforming the health care landscape here and nationally.

One measure established the Maryland Prescription Drug Affordability Board, the first of its kind in the nation, and charged it with making high-cost drugs more affordable for state and local governments and developing plans to bring down the cost of expensive, lifesaving medications for all of us.

The second measure established the Maryland Easy Enrollment Health Insurance Program, which allows people to start the process of signing up for health insurance by checking a box on their state income tax returns.

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These Maryland landmark measures are now working well. Thanks to the great work of the Maryland Health Benefit Exchange, more than 100,000 Marylanders have checked the box at tax time noting that they are uninsured and more than 10,000 of them subsequently obtained health care coverage as a result. The affordability board, chaired by former Health Secretary Van Mitchell, is poised this year to implement an upper payment limit action plan, placing a cap on what state and local governments pay for high-cost drugs.

Several states are following Maryland’s innovative lead, establishing similar easy enrollment programs and creating their own boards. In Congress, U.S. Sen. Chris Van Hollen of Maryland has introduced legislation to replicate an easy enrollment program across the country, which could help many more Americans conveniently sign up for coverage, as well as a bill called the We Paid Act to create a comparable board to make sure Americans don’t pay drug corporations exorbitant prices for drugs whose research was paid for largely by the federal government.

More progress was made in Maryland this year, with the passing of a measure sponsored by Sen. Malcolm Augustine and Del. Lorig Charkoudian making it much easier to enroll recipients of SNAP food benefits in Medicaid and one by Sen. Brian Feldman and Del. Ken Kerr to extend subsidies to make health insurance more affordable for young adults. This progress was greatly aided by the General Assembly’s two new health leaders, Senate Finance Chair Melony Griffith and House Health and Government Operations Chair Joseline Peña-Melnyk. Thousands of Marylanders will now gain affordable coverage.

But the work is not done. Roughly 6% of Marylanders still lack health insurance, which creates economic and health risks for them and drives up costs for everyone else. Getting these Marylanders, many thousands of whom are eligible for free or low-cost health care coverage but are not enrolled, into health insurance and making care more affordable is not easy, but solutions are available. We would all benefit by reducing how much we all pay for uncompensated hospital care for the uninsured.

First, we must build on the Easy Enrollment Program by automatically enrolling into Medicaid those who check the box at tax time and are eligible. We are working with Maryland Comptroller Brooke Lierman, Maryland Health Secretary Dr. Laura Herrera Scott and Health Benefit Exchange Director Michele Eberle and their teams to try to make this happen in time for the 2024 tax season.

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Maryland should also provide additional subsidies for those having trouble affording coverage and remove barriers blocking immigrants from getting coverage. Thousands of Marylanders who are working, paying taxes and contributing to our communities often cannot afford or are blocked from accessing affordable coverage. Without health insurance, they and their families go without care or they go to the hospital. We all pay higher health premiums to cover their uncompensated hospital care.

Finally, the General Assembly should expand the authority of the Prescription Drug Affordability Board to allow it to place upper payment limits on what all Marylanders pay for high cost drugs — going beyond its current mandate to focus on drug costs for state and local governments. Far too many people in our state struggle to pay for the drugs they need to stay healthy. Drugs don’t work if people can’t afford them.

All of this is achievable. With Gov. Wes Moore and Lt. Governor Aruna Miller in office, we have statewide leaders who have committed to expanding health insurance to all Marylanders. Our state is fortunate to have leaders in the General Assembly who have consistently supported our efforts for years.

We are close to our goal of giving everyone in Maryland access to the health insurance they need. In 2024, we can once again make real progress and help many more Marylanders live healthy lives.

Vincent DeMarco is president of the Maryland Health Care for All! Coalition.

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