Insurers as well as providers are feeling a pinch. CareFirst BlueCross BlueShield, the state's largest, has also seen its margins decline. In response, it shut down its Medicare and Medicaid HMOs. Now, the legislature is expected to consider extending coverage to the parents of many of those children. Adding coverage bit by bit could blunt the drive of the Maryland Citizens' Health Initiative, a group seeking to influence elections in 2002 to bring about universal health insurance for the state.
Legislators also are interested in a prescription benefit for seniors.
Many seniors lost pharmacy coverage when Medicare HMOs pulled out at the end of last year. And with the federal government talking of extending prescription coverage as a Medicare benefit, the state may be reluctant to try to solve the issue itself. Another issue likely to come before the legislature is a review of the health planning process that requires hospitals and other providers to get regulatory approval before launching certain services. At issue particularly is open-heart surgery. Hospitals that have it want to limit expansion.