The Maryland Health Care Commission reported to the Senate Finance Committee Tuesday that the number of Marylanders without health insurance increased from 690,000 to 740,000 in 2003, or 13.6 percent of the state population. That figure exceeded the 12.8 percent uninsured in 2000.

The commission also reported that 40 percent of the uninsured are between the ages of 19-34, something that lawmakers found alarming.

To counter these problems, Delegate Donald Elliott, R-Frederick, and Barbara Hoffman, a former state senator, proposed some solutions to a work group after Tuesday's commission briefing.

Elliott, who sits on the House Health and Government Operations Committee, proposed a bill to levy a surcharge on the taxable income of Marylanders earning more than 300 percent of the federal poverty level (about $56,000 for individuals and $84,000 for married couples) who do not have health insurance.

The bill, which Elliott plans to introduce along with House health committee Vice Chairman Peter Hammen, D-Baltimore, would mandate a 1 percent surcharge on individuals' incomes and 2 percent on that of couples. The bill includes a one-year grace period.

Health care advocates attending the meeting were supportive, but said the move would be unprecedented.

Senators questioned whether Maryland should become the first state to impose such a tax.

"We're going to dictate people's personal lifestyles" by passing the bill, said Sen. Thomas Middleton, D-Charles, Senate Finance Committee chairman. "That's not something we can take lightly."

The other proposal came in response to commission figures that show that between 2001-2003 the number of employed Marylanders covered through employer-sponsored health insurance decreased 3 percent (to 72 percent).

Hoffman, a state senator from 1983-2003, proposed the Fair Share Health Care plan to reverse that trend. The plan calls for the state to require Maryland employers with at least 10,000 full- and part-time employees to spend at least 8 percent of payroll costs on employee health coverage.

Opponents in the work group charged that only two for-profit companies would be affected by the plan -- Wal-Mart and Giant Food Inc.

Hoffman countered, arguing that "this is not a target bill."

According to the advocacy coalition Health Care For All!, Montgomery County Executive Doug Duncan, Baltimore City Mayor Martin O'Malley and a Giant Food vice president will publicly endorse this plan Wednesday afternoon in Annapolis.

Middleton promised there would be some new legislation this year because the committee wants to make health care affordable, accessible and attractive to 20- and 30-somethings.

As a start, both the House and Senate passed bills in 2004 requiring the commission to investigate the affordability of private health insurance and to present its findings in January 2006.

The commission presented its interim report to the Senate Finance Committee on this issue Tuesday. It stated that, while more lower-income people are now uninsured, fewer medium-income people now go without insurance. Young Marylanders, it said, do not pay for health insurance because it is too expensive for individuals to purchase and for employers to provide. It costs the state millions of dollars annually to support the uninsured.

"We seem to have designed a plan that doesn't accomplish what we wanted it to do," said Sen. E.J. Pipkin, R-Queen-Anne's, complaining that many young Maryland adults "still play health insurance roulette."

Copyright © 2005 University of Maryland Philip Merrill College of Journalism