BALTIMORE - Republican lieutenant governor candidate Kristen Cox paid a visit to Mayor Martin O'Malley's backyard Thursday, using a speaking invitation at Johns Hopkins University to defend the Ehrlich administration's record on health care.

Cox repeatedly referred to the governor's declared health care priority of expanding flexibility and control to all Marylanders, including the disabled, the mentally ill, the poor and elderly. She rattled off a number of health care achievements she says Gov. Robert L. Ehrlich is responsible for, ranging from prescription drug assistance to emergency management services to stem cell research.

"We have a substantial, tangible track record on these issues," she told a mix of faculty and students at Hopkins' Bloomberg School of Public Health.

Cox has served under Ehrlich as secretary of the department of disabilities since 2004. She says that if elected lieutenant governor, she will play a central role in education, health and human services.

She told the audience that a $1.2 billion increase in Medicaid spending over the past four years is a testament to Ehrlich's sincerity about tackling a vexing health care issue that around the country is taking a growing proportion of state budgets.

Cox's appearance followed by a week a similar visit before the same forum by O'Malley, Ehrlich's Democratic opponent.

The secretary used the opportunity to challenge students to think more deeply about health care solutions. She said that most people were looking for an "easy answer" to bringing care to all Marylanders.

"All people should have access to health care, we all believe that," she said. "The question is how do you get there?"

Cox was put on the defensive when a questioner, citing U.S. Census Bureau data, asked why he should have confidence in the Ehrlich Administration because "there are 200,000 more Maryland residents that are uninsured since Governor Ehrlich took office."

Cox disputed the data, which she said is a frequent refrain from the O'Malley campaign.

She called the data misleading because it includes residents of varying ages who qualify for some form of health insurance but are not signed up. Many of those people, she said, "are not the chronically long-term uninsured."

Speaking after the event, Cox did not deny that the state had a problem with its uninsured.

"It's a priority for us to make sure we find solutions to the uninsured in the state," she said. "We want to make sure the numbers we use are accurate."

Tom Oliver, an associate professor in the department of health policy and management, came away Thursday wishing he had seen more.

"It was a nice piece of work on her part — very articulate," he said. "But if you want to do better, where are you going to come up with those resources? Are you going to cut taxes?"

Paul Perrin, a Ph.D. student who last week attended O'Malley's appearance, said he also was impressed with the way in which Cox laid out Ehrlich's case. Still, he said there were few substantive differences between Cox and O'Malley in terms of concrete plans for the next four years.

"To hear how similar their plans were was surprising," said Perrin, who said he remains unsure about which candidate he will vote for in the Nov. 7 election. "They both said the right things. Getting health care to all was their ideal."

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