How can the state protect medical patients while curbing medical malpractice insurance premiums that have jumped 30 percent in each of the last two years? Are slot machines a good source of revenue to pay for needed programs or a social ill that disproportionately taxes the poor? How will the Governor address a $310 million budget shortfall?
These are some of the questions on legislators’ minds as they prepare for the 419th Regular Session of the Maryland General Assembly, which convenes Jan. 12 and adjourns April 11.
Potomac’s representatives said in interviews that they expect a feverishly busy, perhaps acrimonious 90 days, and all of them have plans to introduce bills — on subjects ranging from biotechnology to domestic violence to keeping non-native oysters out of the Chesapeake.
The official convocation Jan. 12 will be preceded by a special session Jan. 11, the continuation of a Dec. 28 session called to address the skyrocketing cost of medical malpractice as well as funding for the University of Maryland and other issues. Several gubernatorial veto overrides are expected during the Tuesday session.
“Tuesday is an important day and may very well set the tone for the 2005 session,” Del. Bill Bronrott (D-16th) said.
The legislature passed a medical malpractice reform bill at the Dec. 28 special session that caps non-economic (“pain and suffering”) payouts and toughens standards for trials while providing a stop-gap fund to subsidize doctors’ malpractice premiums by eliminating an exemption for HMOs on the statewide 2 percent insurance tax.
Ehrlich objected to that funding mechanism saying that the HMO tax would be passed on to consumers. He wants to pay for the insurance subsidies from the general fund. He has promised to veto the malpractice bill.
Bringing slot machines to Maryland, a persistent issue since Ehrilch took office in 2002, is likely to come up again this session, legislators said.
But most of Potomac's representatives said they are more concerned with social programs, stimulating economic growth and addressing a more than $300 million structural budget deficit this year, which is expected to rise in coming years. In an unprecedented move, Ehrlich has not yet presented his proposed budget to legislators, as is normally done in the weeks before the legislature convenes. Representatives say it is almost impossible to talk about resolving the budget problem without knowing how the governor plans to raise revenue, or more likely, where he plans to make cuts.
Sen. Rob Garagiola (D)
Medical Malpractice: “I was on the senate task force on medical malpractice. We probably met about 10 times over the nine-month interim and our meetings lasted from four to six to seven hours. … Clearly we’ve got a crisis and something needed to be done. The Governor called a special session between Christmas and New Years. I don’t understand what the logic of that was.”
The long-term solution to the skyrocketing rates, Garagiola said, is a three-pronged approach: tort reform, insurance reform, and new measures to prevent patient injuries.
“Some had advocated doing a lot of tort reform. But no matter how much reform you did it would not have an impact on their premiums for three, four, five years. When everyone is clamoring, ‘we have to do lawsuit reform, we have to do lawsuit reform,’ that’s not going to have an impact for several years. Everybody knows that.
“The best way to reduce the lawsuits is to reduce the errors, reduce the injuries and there are things we can do to do that. …The other thing is insurance reform.”
We have long-term reforms which will lead to lower premiums in the future, not immediately. That’s the tort reform, that’s the insurance reform, and that’s the patient safety reforms. And you need all three. Not just the tort reform.”
Slots: “I’m actually getting sick of it personally. Is it a mechanism to make sure that we don’t have to cut a lot of programs? It certainly is, [but] I think it should just stay off the table for the next two years.”
“The dynamic is different throughout the state for this issue. Politically, it’s a winning issue for the governor. For Montgomery County it’s not.”
Other Bills Planned: “I’m going to be introducing one bill that’s called the Assault Weapon Criminal Penalty Enhancement Act,” Garagiola said. After talking to senators who voted against the assault weapons ban last year, he determined that the outcome would be the same in 2005.
“What I’m looking to do is increase the penalties for those who use assault weapons in crimes. It would enhance criminal penalties for those who use assault weapons in the commission of crimes. The punishment would be the particular crime the committed plus up to an additional 20 years,” Garagiola said.
Another bill would foster renewable energy use by providing tax credits for renewable energy jobs. Last year, Garagiola launched a Solar Energy Grant Program. The tax credit would be paid for by phasing out the Maryland Mine Coal Tax Credit. “The coal industry is doing very well I think and we need to consider whether this tax credit for coal is really necessary,” Garagiola said.
The Driver Responsibility Act would create an MVA-assessed fee for drivers with DUI convictions or more than six points on their drivers licenses. A similar law in New Jersey has reduced traffic accidents and fatalities while producing a significant revenue stream, Garagiola said. “In New Jersey they raised about $130 million in 2003. In Maryland I think the fiscal estimates are in the range of $55 million or so. It’s not insignificant money,” he said. The money would go into the transportation trust fund and a fund benefiting first responders, police and fire and rescue personnel, “to ensure that they’ve got the resources they need and we’ve got enough officers on the street.”
Comments: “Another big issue is healthcare, both from a perspective of the rising number of uninsured but also it’s become so expensive for those who do have health care in one form or another.
“I hear from constituents about how healthcare costs are going up for them. … I see that issue looming, and I think the longer we don’t deal with it its going to get to be a bigger and bigger issue.”
Del Jean Cryor (R)
Medical Malpractice: “I think it was essential that [the special session] happened. I think it had drifted along and yet the situation got to be far worse than anyone had really anticipated.
“I met individually with physicians over the summer all on this same subject and you could see that it was simply continuing to grow as a crisis. … I think really the governor should be praised for having the courage to say we need to have a special session. …. By the governor calling in this special session he had the control over the bigger part of it, which is we are going to have the short term solution.
“The physicians’ own insurance company had a surplus of over $100 million — they could have reduced premiums.
Did I think it was the best bill I had ever seen? No I did not. But I had to vote for it. It was the only bill I had on my desk.
“I do think the governor has a better bill. I do think the veto will not survive and I do think that the bill that has the HMOs in it will move forward.”
Slots: “I think it’s there every year. … Normally, the more you study something the easier it becomes to understand. The more you know it the simpler it becomes. The more work you do on slots the more complicated it gets. The more difficult it gets.
“I don’t particularly care for slots. I would like to be able to fund Thornton with something else than slots but I’m not for raising taxes.
“First, the area where they would go has to have an agreement and secondly the money has to go to the education fund.
“I will never vote for a slots bill that has the money going to the general fund. Never, never, never.”
Other Bills Planned: “I’ve met with the Comptroller, [former] Gov. [Donald] Schaefer, to ask for his support for putting my back-to-school week no-sales-tax-on-clothing bill forward,” Cryor said. The bill would give parents a break on sales tax up to $100 during the last week of August.
“He’s very enthusiastic about it. I sat down with him with all of my arguments ready … and he said, ‘Oh Jean, I’m backing you 200 percent.’
“We haven’t been able to do it for the last couple of years because of the budget deficit but I really think its time to try it again.
“The second thing is I’m always concerned about the tax structure being on Ways and Means and I successfully got through for the first time a task force that’s operating right now looking at the tax structure looking at older people, retirees,” Cryor said. The task force has yet to make its report.
“I drafted a bill about seeing what we can do about … these HAM radio towers. About not allowing them to go forward the way they have been. It’s really putting a gun to people’s head,” Cryor said.
In response to the rash of traffic accidents involving teenagers, “I have put the bill in that raises the fine on the adult that buys alcohol for a youngster to $1,000,” Cryor said. “The police chief has said that he will come and testify. It will slow it down considerably, because no one is going to fork over $1000.”
In terms of higher education, Cryor said she voted for legislation that will put a cap on tuition increases at the University of Maryland. The governor and the legislature have tangled over UMD funding. “The governor has come forward and said that he would put millions of dollars into higher education and I think that is the result of this legislation that has come forward,” Cryor said.
COMMENTS: “I’m going to do everything I can to be absolutely positive that the health system that we have, the excellent health system, continues to be there and be available.
“I’ve spoken with the governor’s office about the property tax increase and have been assured by the governor’s office that they are going to take action on this. I don’t have any specifics on it but yes, there is going to be some relief on property tax.
“We’re now in that situation and its become very, very partisan and I think the governor was surprised, very surprised that this would happen When I talk with him I find him to be extraordinarily reasonable and very understanding. When you’re with him on a one on one he has a warmer more relaxed way. He understands my district and he likes my district. He wants to be involved more and more in this area.
"His staff is two years older now and they know how to get it done. I think he’s better as governor than he was when he came in. his staff is better. And he’s more accustomed now to the hardball that’s going on.
"Partisanship to me is the last refuge of a bad bill or a bad issue."
Del Brian Feldman (D)
Medical Malpractice: “The legislature passed I think a pretty good balanced piece of legislation. … I’m hopeful that somehow someway that we can put the political rancor behind us.”
Slots: “I think at this point we’ve spent two years as a legislative body spending far too much time on the subject. … I think its at best 50-50 that the Governor will put in any kind of a slots bill.
“I’ve never had to take a vote on the subject. It’s never come to the floor of the house. I’m kind of reluctant to comment on a specific piece of legislation that has never come before. I don’t think it’s helpful to take a black and white view of this kind of legislation.”
Other Bills Planned: Feldman plans to introduce the Biotechnology Incentive Act, which would give Maryland venture capital firms a tax credit for investing in local biotechnology companies. Though Montgomery County and other parts of Maryland are one of the major biotechnology centers nationwide, the area lacks enough venture capital investment in biotech, Feldman said. “We’re starting to lag a little bit behind here,” he said and the Incentive Act would address that.
Feldman said that like any bill dealing with tax credits, the biotech act might face some opposition but that it makes economic sense because it will stimulate economic growth now with the provision that payouts won’t come for several years. “If you invest today you actually wouldn’t be able to utilize the tax credit until 2008, ‘09, ’10,” he said. Furthermore, the state stands to benefit from the success of investors who receive the tax credit. “If one of the companies that benefits from the credit does very well … over and above some percent they pay back to the state,” he said.
Another bill, which Feldman plans to introduce together with Sen. Garagiola (D-15th) would give a procurement bonus to disabled-veteran owned businesses. “Basically, a certain percentage of certain state contracts would go to business owned by service-disabled veterans,” he said.
Comments: “A bill that could be interesting is that we had, at the federal level, the assault weapons ban expire, so it’s now up to the states to step up and do what the want to do and need to in this area,” Feldman said. A Maryland assault weapons ban was defeated in senate committee last year by one vote.
“This is really the first test subsequent to the expiration of the federal ban,” Feldman said. “I’m hopeful we can make some progress here at least in Maryland on assault weapons which have no particular purpose other than to kill.”
On the subject of the legislature’s relationship with the governor, Feldman said, “You’ve got to at some point demonstrate some flexibility and some leadership. … After two years it still remains to be seen whether the governor is able to do that like some of his other counterparts [like Gov. Warner of Virginia And Gov. Rendell of Pennsylvania] have done.”
“I think that this session coming up is critically important if for no other reason that in ‘06 coming up we’ve got an election year,” when less is generally accomplished, Feldman said.
Del. Kathleen Dumais (D)
Medical Malpractice: “I think that the bill that we passed was a very good bill. Tort reform isn’t the only answer and probably the most important change in that bill was the amendment proposed by Del. [Luiz] Simmons (D-17th)” which allows the Insurance Commissioner to consider insurers’ surpluses in considering rate hikes.
“Only 5 percent of claims go to trial and of that 5 percent 4 percent are defense. … What’s happening is the cases that are getting tried and the high claims are the bad ones” because there are so many filters in place for early resolution.
Slots: “I unfortunately think we’ll see slots again. … I can’t really tell you what to expect. But it’s certainly going to be around.”
“I’m not a fan of them. Until I sort of see the bill I can’t really tell you. I certainly don’t want them here in Montgomery County.”
Other Bills Planned:
Together Sen. Sharon Grosfeld (D-19th), Dumais plans to submit a bill on juvenile competency. At the present there is there are no court standards for criminal trials and no formal structure for offering social services to juvenile offenders who are found incompetent due to mental health problems or developmental disabilities. The result is that the young offenders get caught in bureaucratic limbo and often later commit more serious crimes which might have been prevented had they received social services after an earlier offense.
Other bills would strengthen domestic violence laws, “which are very good but we’ve got a few little tweaks that we’ve got to work on.” Another would provide more severe penalties for refusing breathalyzer tests.
Dumais’ judiciary committee will review child support guidelines and payment formulas, which it is required to do every three years by federal mandate. “It’s time to look at that again. We have not changed our guidelines since they were implemented in 1988.”
Sen. Brian Frosh (D)
Medical Malpractice: “We’ve done a good comprehensive job on that.
“There’s not a state that’s not dealing with this right now. [The bill is] comprehensive, it’s balanced it’s fair, it’ll do the job, and in that sense I am happy with it.”
Slots: “I’m sure they will [come up again]. I’d be surprised if something passes this year but I don’t know. It’s always a possibility. I think as the [governor’s] term gets later it gets more unlikely. I’m not fan of slots. I’m not a supporter. I have not been a supporter. I can’t say there are no circumstances in which I would vote for them, but I haven’t seen any.”
Other Bills Planned: “One has to do with the administration’s land sales. They’ve tried to deal park land, environmentally sensitive land, to private developers and I think we’re going to pass some legislation that’s going to subject that to greater scrutiny.”
“Another one has to do with the Governor’s talking about introducing an alien oyster, an Asian oyster, in the Chesapeake Bay. … All the national experts have been saying that this is dangerous and needs much more research, much more work before a determination can be made that this is safe. I think we’re going to put the brakes on that too.
“The fiscal health of the University of Maryland is going to continue to be an issue. The governor just promised yesterday to put more money in the UMD budget. The question is whether we’re going to override his veto of house bill 1188 [which established a funding mechanism for Maryland’s state university system for the next three years, guaranteeing a roll back of some of the cuts that Ehrlich had made].”
Comments: “[Efforts at cooperation with the governor] don’t look very good. This governor doesn’t really know how to work with the legislature. He called us into special session [on medical malpractice]. He didn’t have a plan. As soon as it became clear that the legislature had a plan he walked a way from it. … That’s not the way you deal with policy makers. It’s not calculated to generate either good will or good policy. I think he made it clear that he’s not really interested in solving problems.”
Del. Bill Bronrott (D)
Medical Malpractice: “I voted for the bill. If it’s vetoed I will support overriding.”
Slots: “I guess slots will come back up again which would be very unfortunate because A, we don’t need slots and B, it’s a major distraction from the big issues of the day. … It’s the same players that continue to try to put this square peg in the round hole. I would rather see us spend our time on the bigger issues of the day and being constructive in the area of education transportation and healthcare.”
Other Bills Planned: Bronrott, known as an advocate of highway and pedestrian safety is planning several transportation bills, particularly relating to teenage drivers. One bill would forbid new drivers from carrying non-family, teen passengers during their 18-month provisional license period.
Another bill would prevent young drivers from using cell phones while driving during their learner’s permit and provisional license and require that all drivers use hands-free devices to talk cell phones while driving.
A third bill aimed at teen driver safety would increase the number of adult-supervised driving hours required for teens during their learner’s permit period. The law currently requires 40 hours and Bronrott’s bill would raise that number to 60 hours with the further requirement that 10 of those hours be at night. The bill is based on the recommendations of the National Transportation Safety Board.
Other legislation Bronrott hopes to introduce includes a bill allowing Montgomery County to use speed cameras to issue fines to those driving 10 or more miles per hour over the speed limit in residential areas. He proposes a “Hummer Surcharge” which would tack on a $750 tax to the registrations of “supersized SUVs” weighing 6000 pounds or more. “They beat up our roads, they pollute our air, they make us even more depended on foreign oil and they are a public safety threat as well because in a crash they win and everybody else loses,” Bronrott said. The tax would only apply to very large SUVs and not to trucks or standard SUVs like the Jeep Grand Cherokee or Ford Explorer. He also will propose a bill curbing probation before judgment, which he called “a mere slap … [that’s] used all the time with drunk and drugged driving.”
“Getting a bill passed when typically 2500 other bills have been introduced during this condensed period of time is very difficult,” Bronrott said, but in light of the tragic teen driving fatalities of the last few months, “I think you will see a lot more focus on teen driving and highway safety in general,” he said. He added, “You’ll find that everybody’s personal priorities will shift a bit as they get into the session.”
Del. Susan Lee (D)
MEDICAL MALPRACTICE: “The bill that we passed I thought was a pretty good bill. One good thing was it capped the rates for malpractice premiums at 5 percent. It also had a measure that required that patients who file medical malpractice suits to have an enhanced certificate of merit.
“We want to keep these good doctors around and practicing. My concern, too, was protecting the victims too of a bad doctor.”
SLOTS: It might [come up again]. I’m against slots because I don’t think it’s a good way to raise revenue. You’re dealing with an unpredictable revenue source.
There are problems with addiction that need to be addressed. Addiction to gambling is a serious, serious thing … [It’s] A drain on the criminal justice system. What does it do to neighborhoods, too.
“[It’s] not a responsible and prudent way to raise revenue. I think you’re creating greater problems than you’re trying to serve.”
OTHER BILLS PLANNED: “I’m going to be introducing a bill to protect people from spyware. I’m trying to craft something and put the finishing touches on the bill so it’s not intrusive to commerce. … It would give at least law enforcement the ability to go after those that use spyware and attach it to your computer.
“We want to go after those that do so without the consumer’s knowledge. What they do is they go in there and they find out all sorts of things about you.”
“Of course I’m going to introduce again the identity theft task force that last year passed the house but didn’t get through the senate.
“There is also a bill that I’m going to introduce dealing with setting a time limit” requiring courts to order HIV tests for rapists in most cases. The current law only says that the test must be “timely, whatever timely can mean,” Lee said.
“It’s a safety issue too, and a health issue. Also the if victim doesn’t know it creates a lot of anxiety and emotional turmoil.”
COMMENTS: “Education [is a priority]. Ensuring that we get full funding for our schools. For renovation projects, and making sure no child really is left behind. I think Doug Duncan is doing a great job in elevating this issue to the focus of everybody and making it an important issue. I hope we don’t let down our kids.
“I’m hoping we’re going to move towards being more bipartisan and working in harmony and compromise. I don’t think [the partisanship] good for the state and the people that we serve.”
Del. Marilyn Goldwater (D)
Medical Malpractice: “The thing I really wonder about is why the insurance commissioner allowed those big hikes in the first place. … It isn’t just the doctors’ malpractice that has jumped. The nurse midwives has jumped, the nursing homes’ insurance jumped. I’ll support the current bill but I think we’re going to need to some work during the session by really getting to the heart of the problem. We’ve gotten the premiums down but that’s not a long term care solution”
Slots: “I suspect slots will be back again. They’re supposedly the panacea. First of all, it’s poor public policy and secondly it’s an unstable source of revenue. If you look at the other states that have gambling, it’s up and down: some places it’s a source of revenue and other places it’s not. It’s not a way to run a state.”
Other Bills Planned: “In terms of my own agenda, I chair the subcommittee on long-term care on the Health and Government Operations Committee. And I’m looking to put in place a roadmap for the state to follow to ensure that our senior population gets the services that they need. Right now it’s just a patchwork. … We have a very fast growing elderly population.”
Goldwater asked various government agencies to submit needs assessments for seniors. “You can’t just have a hit-and-miss delivery system because it really does cost more money” to pay for responsive care than preventative care, she said.
Goldwater also mentioned an Older Adults Community Waiver that would attempt to keep people out of the nursing homes. “Assisted living is an enormous problem and something that my subcommittee is going to spend some time looking at,” she said. The system needs greater safeguards and protections. The committee will also look the problem of low salaries for personal care attendants, which have not been increased in 16 years, Goldwater said.
Comments: “I see it as a contentious session coming up, first of all because of the veto overrides or the potential overrides. Second, because we have no idea about the governor’s budget, he’s holding it very close to the vest. … Hopefully we’ll get through it. Somehow we always do.”
“[The governor] hasn’t accomplished very much. He’s very stubborn. It’s surprising because after all he was in the legislature. And he knows legislators. But he has to be able to work with them."