“A river cuts through rock, not because of its power, but because of its persistence.” – Jim Watkins
There are just three days left until Sine Die, the official close of the 2017 session of the Maryland General Assembly, and this year has proven to be a political roller coaster. Of course, things can change at the last minute, but we have a pretty good sense of how the issues of greatest importance to hospitals are shaping up.
All in all, this is closing out as a very successful General Assembly session for hospitals. Here’s a quick overview of how hospitals fared on the three top priorities for the field:
- Behavioral health – Significant progress was made on Maryland’s behavioral health crisis: funding increases for community-based behavioral health providers; full funding (an additional $7 million this year and $35 million next year) for the state’s three Institutions for Mental Diseases; and expansion of Medicaid’s telehealth program, along with several other changes to address the crisis in Maryland.
- Medical liability – We turned back bills that would have tripled the cap on non-economic damages and expanded the cases in which punitive damages could be awarded. We also expanded support for the creation of a no-fault birth injury fund, a good accomplishment for a very tough haul.
- Medicaid tax – This was a tough year for the state spending plan, and elected officials had many budget gaps to fill. After Governor Hogan delayed the promised $25 million spend-down of the $365 million tax for fiscal year 2018, we secured a $70 million commitment over the next two fiscal years to help make up the difference.
And how we did on some other key issues:
- Physician alignment – Hospitals can now collaborate financially with physicians, an essential component for success under the care redesign programs in the All-Payer Model
- Tax-exemption – Legislators rejected legislation that would have required hospitals to display the value of their not-for-profit tax exemptions alongside the value of their community benefits contributions, a threat to hospitals’ tax-exempt status.
These are just a handful of the more than 200 bills MHA, along with your hospitals’ legislative teams, has been engaged with this session. As we do each year, we’ll send out at midnight Monday a quick summary of where we ended up, which will be followed by a post-session hospital action plan, a detailed session summary, and a PowerPoint presentation so you can share outcomes of the session with your board, staff and the public.
This was a challenging but fruitful session. The physician alignment legislation is a major step toward success under the All-Payer Model, and while the delay of the Medicaid tax spend-down was disappointing, the additional commitment in the budget’s out years offers some measure of security.
As we begin to digest the proceedings and politics of the past 90 days, it reminds me that our state’s lawmaking process is quite deliberative, with big changes rarely occurring in a single year. Instead, it’s steady persistence over time that effects transformation, and taken as a whole, this year’s movement has been in the right direction.