By RACHEL LEVEN
ANNAPOLIS (Jan. 29, 2010) - Walk into Hagerstown's Community Free Clinic and you can see exactly whom health care reform, state or federal, is meant to help.
The waiters and bartenders who make too much to qualify for Medicaid but too little to afford insurance, those who have been responsible with finances but were let go due to the recession, and others whose stories can't be generalized come here for free treatment.
"It's especially hard for those people who have always been responsible, who have always been insured. They are humiliated to have to come here," said Executive Director Robin Roberson. "They feel like they're taking advantage of something that they shouldn't, but the reality is that those are the people that we are here to care for."
The federal health care bill that was supposed to help many of these people is in trouble. But supporters of reform in Maryland believe they could bring state-based legislation to Annapolis as early as 2011 if the federal bill does not survive.
Maryland has expanded health care coverage to more than 100,000 previously uninsured citizens under Gov. Martin O'Malley. The state went up in national ranks from 44th to 16th in health care coverage for adults during that time, according to the Maryland Health Care for All! Coalition.
But 595,000 Marylanders, or just over 10 percent of the state's population, remain uninsured, according to Families USA.
Maryland's own legislature is waiting for the federal bill to pass or fail before taking up health care at the state level. Since Medicaid, the main source of health care for low income individuals, is dually funded through the state and federal governments, state legislators feel it is prudent to see how much money Washington is giving first.
But even if the federal bill fails, health care reform would not be a lost cause in Maryland, said Darrell Gaskin, a University of Maryland associate professor of health economics in the Department of African-American Studies.
"Doing nothing ... is really unsustainable because health care costs are going to rise," said Gaskin, who is involved in the state's health care movement. "Something has to be done."
Even state legislators who oppose the federal health care bill agree that health care is an important issue.
Delegate Patrick McDonough, R-Baltimore County, wanted the state's attorney general to sign a petition against the federal health care bill, but said he is not against expanding health care. He is against big government, which he sees as the reason for high unemployment and for people's inability to afford health insurance.
"(The federal bill) would create nuclear size Medicaid obligations for state taxpayers. The only reason the bill passed was because of these corrupt deals for (certain states)," McDonough said of the deals made with Nebraska and Florida, among others. "Maryland taxpayers will pay 'Obama-Care' Medicaid costs and also pay for Medicare in these other states (under the federal plan)."
McDonough would support legislation expanding access to health savings accounts and catastrophic insurance policies, as well as increasing tax deductions.
Expanded health savings accounts would allow individuals to purchase limited coverage for a certain number of doctor visits and treatments, as well as allowing them to keep their policies when they switch jobs. A catastrophic insurance policy covers emergencies and unforeseen illnesses.
The delegate contends health care reform is important but it needs to be done correctly.
"If there's any state in the nation where stupid health care would pass, it's Maryland," McDonough said.
But Barbra Lancelot, a Montgomery County resident who lost her insurance when she lost her job, offers a different solution for statewide reform. She wants a single (payer) care system that is the equivalent of Medicaid or Medicare for all, but she believes it couldn't happen on a national level anytime soon.
So for now, free clinics such as the Community Free Clinic in Hagerstown, which only serves Washington County residents, will continue to have a place among constituents.
The Community Free Clinic receives no federal or state funds because its board wants to serve those who might "fall through the cracks," and helping Medicaid or Medicare patients could monopolize their time.
According to the National Association of Free Clinics there are more than 1,200 such free clinics helping patients like Lancelot throughout the United States.
"Basically you just have to go on a begging tour and tell your sad story over and over again," said Lancelot. "That's what I've done over the past three years."
One thing Lancelot believes:
"If it ends up being states leading the way (to health care reform), I think Maryland will be one of the states to cross the finish line first."
Capital News Service contributed to this report.