Federal shutdown bad news for Maryland

For the first time in 17 years, much of the federal government has shut down. This is bad news for Maryland and the nation's economy and for the public that benefits from a wide array of public services.

The parts of the federal government that haven't shut down are either "essential" (mostly activities that protect life and property); are funded outside of the appropriations process (like Medicare and Social Security); or have other funds available, at least for a little while (for example, Medicaid has enough money for the next quarter, and housing vouchers will be unaffected in October).

But lots of other important programs will be affected, including many that help our most vulnerable neighbors. For example:

• Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is not funded for FY 2014. States do have a few funding streams they can use to temporarily cover the loss, but they won't last long.
• Temporary Assistance to Needy Families (TANF) has now expired. States should have already appropriated the matching funds required for the program, and could potentially use these funds to maintain the program until a new appropriation or continuing resolution is passed.
• Child care funding is in the same situation as TANF.

If you want to learn more about a specific program, check out the contingency plans by federal agency.

Here are a few estimates of what the shutdown will cost Maryland:

• Furloughs could cost Maryland $5 million a day in income and sales tax collections and perhaps $15 million a day in overall economic activity, according to the governor's office.
• Dr. Daraius Irani, executive director of the Regional Economic Studies Institute at Towson University estimates that a partial government closure could mean between $18 million and $68 million a day in lost income for Maryland workers, and between $700,000 and $2.5 million a day in lost income tax collections. His analysis does not include lower tax collections from furloughed workers cutting back on their spending.
• Dr. Stephen Fuller, director of the Center for Regional Analysis at George Mason University, estimates the DC region (not just Maryland) could see losses up to $200 million a day. Dr. Fuller's analysis excludes tourism and cuts to direct services such as new Medicare or Social Security applications, small business loans, and child-care subsidies.
• The Baltimore Sun also has a slideshow illustrating the shutdown's effects on Maryland.

In other more positive news, the Maryland Health Connection opens at noon today. Part of the Affordable Care Act (ACA), this exchange allows individuals and small businesses to shop for health insurance, including using tax credits if they qualify. Implementation of the ACA is unaffected by the shutdown.

Health insurance coverage up in 2011 but poverty, median income unchanged

The Census Bureau released the 2011 American Community Survey today. The ACS is the primary resource for demographic data at the state, county, local, and sub-local level.

Some Maryland highlights:

Click to enlarge

• Median household income in the state was unchanged (no statistical difference with 2010) at $70,004 in 2011. Once again, Maryland has the highest median income in the nation. Nationwide, the median household income is $50,502.
• Maryland's poverty rate was also essentially unchanged, at 10.1 percent. The national poverty rate was 15.9 percent.
• Health insurance coverage among younger Marylanders 18-25 jumped 6.7 percentage points between 2009 and 2011, to 81.7 percent. The coverage rate for this population was significantly higher than the national coverage rate for the same age group of 71.8 percent (up 3.6 percentage points). This growth in coverage is partially attributable to the Patient Protection and Affordable Care Act provision allowing children under 26 to remain on their parent's policy.

Of course, there was enormous variation across Maryland in 2011 in each of these categories. Median household income was as low as $38,502 in Allegany County and as high as $98,953 in Howard County. Poverty rates ranged between 4.2 percent in Calvert County all the way up to 25.1 percent in Baltimore City. And health insurance coverage for Marylanders 18-24 (note slight variance due to data availability from statewide age range) varied between 86.4 percent in Wicomico County and 93.9 percent in Montgomery County.

1.2 million MDers to gain healthcare protection

According to a report out today from FamiliesUSA, nearly 1.2 million non-elderly Marylanders with pre-existing conditions will gain needed protection from health insurance discrimination under the Patient Protection and Affordable Care Act (ACA).  That's nearly one out of every four Marylanders under the age of 65 (24.2 percent).

Thanks to the ACA, beginning in 2014 no Marylander (or resident of any other state) can be denied coverage, charged a higher premium, or sold a policy that excludes coverage of important health services simply because of a pre-existing condition. Using historical data about the number of Maryland residents diagnosed with pre-existing conditions, FamiliesUSA was able to estimate the number of individuals at risk of being discriminated against by the health insurance industry. The 1.2 million Marylanders are distributed across the state, including:

• 184,800 in Montgomery County
• 170,900 in Prince George's County
• 167,000 in Baltimore County
• 136,300 in Baltimore City

Furthermore:

• In Allegany and Garrett counties, the share of non-elderly residents with a diagnosed pre-existing condition is 28.8 percent (highest in the state).
• 46.1 percent of adults between 55-64 years of age have been diagnosed with a pre-existing condition that, until the ACA, would have put them at risk of health insurance discrimination.
• Income does not predict likelihood of pre-existing conditions--24.3 percent of Marylanders in households making more than 4x the poverty rate have been so diagnosed.
• The numbers may in fact be much higher, as FamiliesUSA based their estimate on the number of Marylanders currently diagnosed with a pre-existing condition. Many others, particularly those currently without health insurance, may be undiagnosed.

We here at MBTPI are glad that Maryland is at the forefront of the effort to implement the ACA, and will continue to promote policies that meet the needs of all Marylanders, especially those most in need.

Affordable Care Act Constitutional

As you've no doubt seen, the U.S. Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (ACA), including the insurance mandate "tax". This is good news for the millions of Americans without health insurance (or who previously lacked insurance, like the 52,000 Marylanders age 26 and under who now have health insurance through their parents because of the ACA), and the millions more who have insurance but pay the social costs of supporting those in need of care who can't afford it.

Maryland has consistently been in front of other states in terms of implementing the ACA, and this is likely to continue. Barring the Republicans gaining a supermajority in Congress and repealing the act entirely, Maryland is well positioned to take full advantage of the changes now ahead. 

Nonprofit Quarterly has a good roundup of what to expect now that the court has ruled:

• "Expect more opposition advocacy." - Whether this ruling will be a boon for either party in November remains to be seem, but it's definitely an issue that isn't going to go away.
• "Expect resistance to health exchanges in some states" - Not in Maryland, however.  We continue to develop our health exchange as fast as possible.
• "Expect more funding wars."  - This is the outcome that has the most potential for danger to Maryland. If Congress cuts funding, Maryland will have to figure out how to continue making progress with less.
• "Expect attempts to better assist small businesses and nonprofits."
• "Expect increased scrutiny of nonprofit hospitals."

The Week Ahead

Last week we blogged about Maryland bucking the trend of public disinvestment, and the inability of the legislature to compromise on expanded gambling (so far). 

Monday, June 25th

• State Commission on Criminal Sentencing Policy holds a meeting to review and evaluate Maryland's sentencing guidelines and policies. 5:30pm in Training Rooms 1 & 2 of the Judiciary Education and Conference Center, 2009D Commerce Park Drive, Annapolis. 
• Joint Committee on Exchange Financing of the Maryland Health Care Reform Coordinating Council will hold its first meeting. The exchanges are a key part of the Affordable Care Act (ACA), so no doubt the impending Supreme Court decision (see Thursday, below), will be on everyone's minds. 1-3pm in the Joint Hearing Room, Department of Legislative Services, Annapolis.

Tuesday, June 26th

• The Task Force to Study the Court Decision Regarding Pit Bulls will hold a work session. 10am in room 2 East, Senate Building, Annapolis. 

Wednesday, June 27th

• The Workgroup on Access to Habilitative Services Benefits will hold its first meeting. 9am in the Hearing Room on the 24th Floor of St. Paul Plaza, 200 St. Paul Place, Baltimore.

Thursday, June 28th

• Maryland's Medicaid Advisory Committee meets. 1-3pm at the offices of the Department of Health and Mental Hygiene, Lobby Level Conference Room L-3, 201 W. Preston Street, Baltimore.
• Maryland's Venture Fund Authority holds a board meeting. 10am to noon at the offices of the Department of Business and Economic Development in a conference room on the 17th floor of the World Trade Center, 401 E. Pratt Street, Baltimore. 
• Maryland Nonprofits is offering Program Design: From A to Z. For more information or to register for this training go to their events page.
• The U.S. Supreme Court will release its ruling on the constitutionality of the Affordable Care Act. If they rule against the ACA they may do so in whole or in part, and the consequences for Marylanders and others with inadequate access to health care may be significant. Look for a related post on this blog later on Thursday.

Saturday, June 30th

• The Fair Development Coalition is cosponsoring an event to celebrate the passage of HB 457, which mandates that .5% of federal transportation funding go toward job training programs.  U.S. Congressman Elijah Cummings will speak, and a number of other state and local political figures have been invited. Inquires about the event can be directed to Maureen Daly at 443-286-4731 or maureen.daly4@gmail.com, or David Casey at 443-857-0831 or bridgemaryland@aol.com. St. Bernardine Church Hall, 614 Mt. Holly St at Edmondson Ave. in West Baltimore.