Health care reform – harder on more generous states, like Maryland?

Today’s New York Times discusses the potential effects of pending federal health care reform on state Medicaid programs. Specifically in focus are the numerous states — including Maryland– who have exceeded federal standards for eligibility and coverage. The essential issue the the potential cost to states for newly broadened Medicaid coverage under the federal reform plan, and whether the federal legislation would offer additional assistance to states for that expansion.

The bill passed by the Senate on Thursday would move toward universal health insurance coverage in large part by expanding Medicaid, a program whose costs have traditionally been shared by the states and the federal government.

But the roughly 20 states that have already expanded coverage in some form will pay a greater proportion of their new Medicaid costs under the bill than those states, largely in the South, that until now have covered relatively few of their poorest residents.

Maryland has received federal support for its Medicaid program through stimulus legislation, but is still amidst a multi-year effort (initially adopted during the 2007 special session of the General Assembly) to expand Medicaid coverage beyond the federally required populations.

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