THIS PROGRAM IS MADE BY MPT TO ENRICH THE DIVERSE COMMUNITIES THROUGHOUT OUR STATE AND IS MADE POSSIBLE BY THE GENEROUS SUPPORT OF OUR MEMBERS.

THANK YOU.

[♪♪] CONNECTING MARYLANDERS TO THEIR GOVERNMENT, THIS IS "STATE CIRCLE".

>> Jeff: WELCOME TO "STATE CIRCLE."

COMING UP ON OUR PROGRAM THIS WEEK A MOVE TO BUY LOCAL.

AN OUT BREAK OF FOOD BOURN ILLNESS HAS SOME LOOKING TO BUY PRODUCE FROM FAMILY FARMS.

A PREVIEW OF MONDAY'S LEGISLATIVE SESSION IN OUR POLITICAL ROUNDTABLE.

JOINING US ARE REPORTERS MENNATALLA IBRAHIM AND HANNAH GASKILL OF THE DAILY RECORD.

THANK YOU SO MUCH FOR JOINING US.

OUR VIEWERS ARE ACCUSTOMED TO THE IDEA THAT THE LEG SLAR COMES IN FOR 90 DAYS AND OCCASIONALLY, THERE IS A SPECIAL SESSION USUALLY IT'S SOME KIND OF EMERGENCY.

HANNAH WHAT IS THIS ONE ABOUT?

>> THIS SPECIAL SESSION IS ABOUT REDISTRICTING.

THAT DOESN'T MEAN WE ARE GETTING A NEW MAP SOON.

I'VE SPOKEN TO SOMEONE THAT SAID THAT IS NOT ON THE TABLE BUT WHAT IT'S GOING TO DO IS ALLOW VOTERS TO DECIDE WHETHER THE STANDARDS THAT APPLIED TO REDISTRICTING IN 2022 WHEN THE JUDGE STRUCK OUT THE PREVIOUS MAP WILL APPLY TO CONGRESSIONAL DISTRICTS MOVING FORWARD.

>> Jeff: SO THEY ARE TRYING TO ASSURE THAT THE MAP THEY DRAW TWO YEARS FROM NOW TO GET RID OF THE ONLY REPUBLICAN LEANING DEPRESSIONAL DISTRICT IN THE STATE THE FIRST DISTRICT REPRESENTATIVE ANDY HARRIS THEY WANT TO MAKE SURE THAT MAP IS NOT STRUCK DOWN AND IT SOUNDS LIKE SORT OF NASTY BARE KNUCKLES POLITICAL STUFF BUT IT'S PART OF A LARGER NATIONAL BARE KNUCKLES NASTY POLITICAL FIGHT.

>> YEAH, WE'VE SEEN REDISTRICTING TAKING THE FOREFOREFRONT IN NATIONAL NEWS WE'VE SEEN IT IN REPUBLICAN STATES WHEN THEY ARE TRYING TO PUSH OUT DEMOCRATIC REPRESENTATION.

IN MARYLAND WE HAVE A DEMOCRATIC LEANING CONGRESS AND A DEMOCRATIC LEANING SENATE AND WE HAVE AND AND REPRESENTING THE FIRST DISTRICT.

IT SEEMS LIKE THE DEMOCRATS HAVE REPEATEDLY IN THE DA SAID THEIR REASON FOR DRAWING UP NEW MAPS OR ADDING A BALLOT QUESTION TO YOUR BALLOT IN NOVEMBER IS NOT ABOUT PUSHING OUT THE ONLY REPUBLICAN MEMBER.

BUT IT SEEMS LIKE THE G.O.P.

THINKS OTHERWISE.

SO THERE IS A LOT OF PARTISAN TALK THAT I'M SURE WE'RE GOING TO SEE NEXT WEEK.

>> Jeff: DO THEY HAVE ANY CONCERNS IN ANNAPOLIS WHAT ATTENDANCE IS GOING TO BE IN THE FIRST WEEK OF AUGUST?

THE DEMOCRATS HAVE A SUPER MAJORITY BUT THEY WILL NEED THE MAJORITY VOTE TO PUT THE AMENDMENT ON THE BALLOT AND ALSO FOR ANY SUSPENSIONS OF THE RULES TO MOVE THINGS ALONG SPEEDILY?

>> I WOULD BE LESS CONCERNED ABOUT ATTENDANCE IN THE HOUSE.

THIS HAS BEEN A MAJOR ISSUE FOR THEM.

THERE ARE ALSO AN OVERWHELMING NUMBER OF THEM AND, I THINK, YOU COULD HAVE A COUPLE OF THEM MISSING AND IT WOULDN'T REALLY MATTER.

THEY ALSO VOTED TO PASS THE MAP THAT GOVERNOR WES MOORE PUSHED FOR EARLY ON IN THE SESSION THAT SENATE PRESIDENT FERGUSON QUASHED.

I WOULD BE MORE CONCERNED ABOUT THE SENATE WHICH ONLY HAS 47 MEMBERS.

BEYOND THAT, I DO I'M CURIOUS TO SEE HOW CERTAIN DEMOCRATS VOTE ON THIS MAP.

I'M THINKING SPECIFICALLY SENATOR JAMES FROM HARPER COUNTY, SENATOR GILE FROM ANNE ARUNDEL SENATOR HESTER FROM MONTGOMERY COUNTY AND HOWARD OR HARPER, WHO LIVE IN PURPLE DISTRICTS.

AND HAVE TO FACE A REPUBLICAN CONTENDER IN NOVEMBER.

>> AS WE KNOW WE NEED THREE FIFTHS VOTE FROM BOTH CHAMBERS TO PASS THIS LEGISLATION AND GET A VIEW OF BALLOT QUESTION ON THE BALLOT IN NOVEMBER.

AND FROM OUR CONVERSATIONS WITH A LOT OF SENATE LEADERSHIP IT SEEMS LIKE PURPLE DISTRICTS BEING QUESTIONABLE HOW FOLKS ARE GOING TO VOTE IT'S ALSO SUMMERTIME.

IF FOLKS ARE GOING TO WANT TO COME BACK DURING THEIR VACATION TIME OR TIME WHEN THEY ARE FOCUSED ON THEIR OTHER JOBS IS QUESTIONABLE AND I KNOW THE SENATE IS STRESSED ABOUT THAT BECAUSE THAT NUMBER IS VERY LOW.

SO ATTENDANCE WILL REALLY MATTER.

>> Jeff: TELL US ABOUT THE BALLOT LANGUAGE WHICH IS DIGESTING THE CONSTITUTIONAL AMENDMENT INTO A COUPLE OF SENTENCES THAT VOTERS ARE GOING TO SEE ON THE BALLOT AND THAT MAYBE ALL VOTERS KNOW ABOUT THIS?

>> RIGHT.

IN SPITE OF THE LEGISLATURE PASSING A BILL TO MAKE THE BALLOT QUESTIONS MORE READABLE BY LAYMEN, I DID HAVE TO ASK SOME QUESTIONS ABOUT THEM.

LET ME BREAK IT DOWN.

SO THE QUESTION POSED TO VOTERS WILL EFFECTIVELY ASK THEM IF THE SAME STANDARDS IN THE STATE CONSTITUTION FOR DRAWING LEGISLATIVE DISTRICTS SHOULD APPLY TO THE EIGHT CONGRESSIONAL DISTRICTS.

THOSE STANDARDS INCLUDE BEING GEOGRAPHICALLY CONTIGUOUS AND COMPACT.

IN 2022, THE JUDGE RULED THAT THOSE STANDARDS SHOULD APPLY TO CONGRESSIONAL DISTRICTS AS WELL.

WHERE THEY HADN'T APPLIED BEFORE.

SO THIS WOULD ALLOW VOTERS TO DETERMINE IF THOSE STANDARDS SHOULD BE RESET, BASICALLY.

>> Jeff: CAN THE REPUBLICANS CHALLENGE THE BALLOT LANGUAGE?

PART OF THIS THERE IS ANOTHER SECTION THAT HAS YOU ARE THE LEGAL PAPER, HAS CREATES ORIGINAL JURISDICTION FOR THE STATE'S SUPREME COURT TO CHALLENGE TAKE UP CHALLENGES TO MAPS, WHICH, I THINK, THEY DO ANYWAY.

BUT THAT IS ALSO A COMPONENT OF THIS AND GOES INTO THE BALLOT QUESTION, WHICH, I THINK, WOULD BE TAKEN TO COURT IF THE REPUBLICANS WANT SOMETHING CLARIFIED.

>> RIGHT.

REPUBLICANS COULD STILL CHALLENGE THE MAPS.

THE STANDARDS WOULD BE A LITTLE DIFFERENT.

SO UNDER THE BALLOT QUESTION INSTEAD OF STATE STANDARDS, THE FEDERAL ASSEMBLY WOULD BE APPLYING FEDERAL STANDARDS TO 8 CONGRESSIONAL DISTRICTS.

WHAT THE BALLOT QUESTION DOES DO IS ALLOW THE GENERAL ASSEMBLY THE AUTHORITY TO WAIVE ANY CHALLENGE DIRECTLY TO THE SUPREME COURT RATHER THAN HAVING IT WORK ITS WAY THROUGH THE LOWER COURTS AND HAVE A MUCH SHORTER SLOG THROUGH THE COURT SYSTEM THAN OTHERWISE.

>> Jeff: SO THE TIMETABLE ON THIS LEGISLATURE CONVENES MONDAY MORNING, THE BIG HEARING IS MONDAY AFTERNOON.

>> YEAH.

THERE WILL BE THE BIG HEARING IS EXPECTED ON MONDAY THE THIRD.

THE SPECIAL SESSION IS GOING TO BE FROM THE 3-5.

SO THAT MONDAY THROUGH THE WEDNESDAY.

OBVIOUSLY THE BIG HEARING IS EXPECTED ON MONDAY BUT THINGS WILL TRICKLE DOWN INTO THE UPCOMING DAYS SHOULD THEY NEED IT.

WE'RE STILL UNCLEAR ABOUT EXACTLY THE PROCEEDINGS OF THE THREE DAYS ON THE WHOLE.

BUT THAT IS WHAT WE'RE EXPECTING FOR NEXT WEEK.

>> Jeff: WHILE WE ARE ON THE SUBJECT ARE THERE OTHER BALLOT QUESTIONS THAT MARYLAND VOTERS WILL HAVE TO MAKE DECISIONS ABOUT COME NOVEMBER?

>> THERE ARE.

SO THERE ARE TWO.

THE LEGISLATURE, I BELIEVE, ACTUALLY IS TAKING ONE OF THE ALREADY PUBLISHED BALLOT QUESTIONS BACK UP BECAUSE IT IS A DUPLICATE.

SO YOU'RE LIKELY TO SEE THREE QUESTIONS ON YOUR BALLOT.

INSTEAD OF FOUR.

THE DUPLICATED QUESTION IS WHETHER OR NOT VOTERS LOOK LIKE THE NEGOTIATING PROCESS FOR STATE EMPLOYEE CONTRACTS TO CHANGE.

IT PASSED, I BELIEVE, ON PARTISAN LINES, EXCUSE ME.

AND THE GOVERNOR SIGNED BOTH VERSIONS OF THE BILL THE SENATE AND THE HOUSE.

SO CURRENTLY IT IS APPEARING TWICE ON THE BALLOT.

>> Jeff: SPEAKING OF GOVERNMENT WORKERS MANY WROTE RECENTLY ABOUT THE IMPACT OF ALL OF THE CUTS IN FEDERAL EMPLOYEES IN THE WASHINGTON METRO AREA AND HOW THE ECONOMIC IMPACT HAS BEEN A LITTLE BIT DIFFERENT ON THE TWO SIDES OF THE CAPITAL BELTWAY.

MARYLAND VERSUS VIRGINIA.

WHAT DID YOU FIND?

>> YEAH, WE FOUND THERE IS A STARK DIFFERENCE BETWEEN THE WAY THE ECONOMY HAS UNFOLDED FOLLOWING THE TRUMP ADMINISTRATION'S CUTS TO THE FEDERAL WORKFORCE IN MARYLAND VERSUS IN VIRGINIA.

IT SEEMS LIKE FROM WHAT ECONOMISTS ARE SAYING VIRGINIA'S ECONOMY HAS BEEN ABLE TO BOUNCE BACK OR NOT FEEL AS MUCH OF THE BLOW THAT MARYLAND HAS FELT.

BECAUSE THEIR ECONOMY AND WORKFORCE IS RELIANT ON A LOT OF VARIOUS DIFFERENT SECTORS WHEREAS MARYLAND IS VERY PRIMARILY RELIANT ON FEDERAL GOVERNMENT, FEDERAL WORKFORCE.

WHEN ALL THOSE CUTS HAPPENED LAST YEAR, OUR RATING IN THE CNBC'S TOP STATES FOR BUSINESS RANKINGS OUR RANKING WENT FROM ABOUT LIKE IN THE BOTTOM 20s TO 49TH WHICH IS THE SECOND WORST IN THE COUNTRY.

WHEREAS VIRGINIA CAME OUT AT 23rd.

OBVIOUSLY LIKE THAT IS A STARK DIFFERENCE AT THAT TIME WE'RE SEEING AND IT IS VERY RELIANT ON THE DIVERSE WORKFORCE.

WHEREAS OURS IS RELIANT ON STRICTLY THE FEDERAL GOVERNMENT.

>> Jeff: YOU CAN READ MENNATALLA IBRAHIM'S WORK AT BALLOT SUN.COM AND HANNAH GASKILL DAILY RECORD.COM AND PRINT EDITIONS OF BOTH PUBLICATIONS EXIST.

GO FIND ONE.

THANK YOU BOTH FOR JOINING US.

WE APPRECIATE YOUR TIME.

>> THANKS.

>> Jeff: WE'LL BE RIGHT BACK.

>> Jeff: NOW, A NATIONAL OUTBREAK OF FOOD-BORNE ILLNESS AS MARREDDERS LOOKING TO MARYLANDERS LOOKING FOR LOCAL GROWN PRODUCE.

>> IT'S BAD THE FACT IT IS IN A BAGGED SALAD MIX.

I HEARD IT'S FROM TAYLOR FARMS.

>> DISCERNING GROCERY SHOPPERS ARE SELECTING WHAT IS GOING IN THEIR CARTS AS THEY TRY TO AVOID BUYING PRODUCE LED TO THE OUTBREAK A PARASITE KNOWN TO CAUSE DIARRHEA.

THERE HAVE BEEN 148 CASES IN MARYLAND ALONE WITH NO COMMON SOURCE.

>> WE HAVE BEEN AVOIDING GETTING SALAD BAGS WHICH USED TO BE SOMETHING WE WOULD DO EVERY NIGHT WITH DINNER.

UNTIL WE HEAR IT'S ALL CLEAR WE WILL KEEP DOING IT.

>> AS A PRECAUTION... >> I'M BUYING LOCALLY.

I'M BUYING AT FARMS THAT GROW THEIR OWN VEGETABLES.

>> A GOOD IDEA ACCORDING TO, PERIODS OF TIME A SENIOR SCLAL LAR FOR SECURITY.

>> IT'S BEEN IRRIGATED WITH WATER CONTAMINATED WITH HUMAN FECES.

THAT DOESN'T OCCUR WITH DOMESTICALLY SOURCED PRODUCE FOR THE MOST PART BECAUSE THEY ARE USING MUNICIPAL WATER SUPPLIES WHICH DON'T HAVE HUMAN CONTAMINATION IN THEM.

>> THE DOCTOR SAYS CONSUMERS CAN PROTECT THEMSELVES BY KNOWING WHERE YOUR PRODUCE IS GROWN.

>> IF SOMETHING IS GROWN LOCALLY IN YOUR HOMETOWN AND THEY HAVE A FARM STAND IT'S UNLIKELY TO BE CONTAMINATED THIS MIGHT BE AN OPPORTUNITY TO BUY FROM LOCAL PRODUCE SUPPLIERS THAT ARE GROWING THINGS LOCALLY.

THE OTHER POINT IS ABOUT WASHING.

AND WASHING CAN DECREASE THE RISK OF THE PARASITE BUT IT CAN'T ELIMINATE IT.

IT'S NOT CASHING IT WITH VINEGAR IT'S MORE ABOUT THE MECHANICS OF WASHING, THE SCRUBBING, DISLODGING WHAT ARE THE EGGS THAT MIGHT BE ON THE LETTUCE.

>> COOKING, BAKING ON BOILING PRODUCE IS ONE WAY TO DESTROY CYCLOSPORA.

>> AND REMOVE THE OUTER LEAVES IT DECREASES THE CHANCES.

>> SHOULD YOU BE UNFORTUNATE TO CONTRACT IT.

>> IT IS NOT LIFE-THREATENING BUT IT HAS THE ABILITY TO CAUSE EXPLOSIVE DIARRHEA.

THE ONSET COMES ON FAST, AS PAST AND IT CAN BE DEBILITATE SNOOK NOT EVERYONE IS PANICKING.

THIS RESIDENT SAYS FOR NOW SALAD IS STILL ON HER TABLE.

>> I FEEL LIKE IF STORES HADN'T PULLED THE BAGS OF THE SALAD KITS OFF THE SHELVES THEY MUST BE OKAY WITH IT.

AND I'VE BEEN EATING BAGGED SALAD FOR YEARS.

AND I'VE NEVER EVER HAD A PROBLEM.

>> I'M NANCY YAMADA FOR "STATE CIRCLE".

>> Jeff: A NEWSMAKER IS MORGAN HENDERSON, SENIOR DIRECTOR OF ANALYTICS AND RESEARCH AT "THE HILL" AT UMBC.

SIR, THANK YOU FOR YOUR TIME.

BIG CHANGES COMING TO MEDICAID.

AND WE'LL TALK ABOUT THAT.

LET'S SPAIN -- EXPLAIN WHY MEDICAID IS SO IMPORTANT.

ONE IN FOUR MARYLANDERS IS A PARTICIPANT IN MEDICAID.

>> YEAH, THAT IS RIGHT.

MEDICAID IS AN ENORMOUS PROGRAM IT'S IMPORTANT TO THE STATE OF MARYLAND AND IT'S VERY IMPORTANT TO THE COUNTRY.

MEDICAID IS HEALTH INSURANCE FOR LOW INCOME PEOPLE AS OPPOSED TO MEDICARE WHICH IS FOR OLDER ADULTS.

MEDICARE 65 PLUS, MEDICAID LOW INCOME FOLKS BOTH CREATED IN 1965 AND THEY ARE BOTH ENORMOUS BUT MEDICAID IN PARTICULAR IS THE ONE UNDERGOING SIGNIFICANT CHANGES RIGHT NOW.

>> Jeff: HOW MUCH HAS MEDICAID EXPANDED?

UNDER OBAMACARE, ELIGIBILITY WAS EXPANDED IN MOST BUT NOT ALL STATES.

SO MARYLAND WAS INCLUDED?

>> ELIGIBILITY HAS EXPANDED TREMENDOUSLY.

BECAUSE OF THE AFFORDABLE CARE ACT, NOW CHILDLESS ADULTS IN THOSE MEDICAID EXPANSION STATES OF WHICH MARYLAND IS VERY MUCH ONE, NOW, CHILDLESS ADULTS ARE ELIGIBLE FOR MEDICAID IF THEY ARE UP TO 138% OF THE FEDERAL POVERTY LEVEL.

THAT IS 21, 22,000 FOR A SINGLE PERSON.

THESE ARE LOW INCOME FOLKS.

PRIOR TO THAT EXPANSION IF YOU WERE ME, 42 YEARS OLD AND DON'T HAVE KIDS YOU ARE NOT ELIGIBLE FOR MEDICAID PRIOR TO THE EXPANSION.

NOW SINCE 2014, YEAH, CHILDLESS ADULTS HAVE BEEN ELIGIBLE FOR MEDICAID IN THESE EXPANSION STATES.

>> Jeff: WHO PAYS THE BILL?

IT'S SPLIT SOMEHOW BETWEEN THE FEDS AND THE STATE?

>> THAT IS JUST SO.

THE SPLIT DIFFERS FROM STATE TO STATE.

IN MARYLAND IT'S 50/50 AND THERE IS A FORMULA IN HIGHER INCOME STATES THE SPLIT 50/50.

OTHER STATES THE FEDERAL GOVERNMENT PAYS A LITTLE BIT MORE BUT MARYLAND 50/50.

HOWEVER FOR THAT EXPANSION GROUP AND THIS IS IMPORTANT, THE FEDERAL GOVERNMENT PAYS 90%.

90 CENTS ON THE DOLLAR.

THE STATE PAYS 10 CENTS ON THE DOLLAR FOR THAT EXPANSION POPULATION.

>> Jeff: AND THAT BRINGS US TO WHAT THE TRUMP ADMINISTRATION WANTS TO DO WITH THE EXPANSION POPULATION, WHICH IS TO ADD WORK OR EDUCATION REQUIREMENTS.

CAN YOU SUM UP WHAT THAT IS AND WHEN IT TAKES EFFECT?

>> CERTAINLY WE ARE TALKING ABOUT SECTION 7111 OF THE HR1 OR ONE BIG BEAUTIFUL BILL.

AND YEAH, THIS ESTABLISHES SO-CALLED COMMUNITY ENGAGEMENT REQUIREMENTS.

BASICALLY WORK REQUIREMENTS FOR INDIVIDUALS IN THIS ACA EXPANSION GROUP.

IT'S ONLY FOCUSING ON THOSE FOLKS THAT GOT MEDICAID COVERAGE BECAUSE OF EXPANSION UNDER THE AFFORDABLE CARE ACT.

DOESN'T TOUCH KIDS.

DOESN'T TOUCH PARENTS OR PREGNANT WOMEN ONLY THAT ACA EXPANSION GROUP AND STARTING JANUARY 1, 2027, THEY WILL HAVE TO BE COMPLIANT WITH THIS COMMUNITY ENGAGEMENT REQUIREMENT, A WORK REQUIREMENT.

THEY WILL HAVE TO EITHER BE WORKING AT LEAST 80 HOURS PER MONTH.

OR IN SCHOOL.

OR DOING COMMUNITY SERVICE OR IN A WORK PROGRAM.

OR THEY RECEIVE AN EXEMPTION FOR ONE OF VARIOUS REASONS.

>> Jeff: HOW ONEROUS IS THIS GOING TO BE IN TERMS OF THE PAPERWORK REQUIREMENT FOR INDIVIDUALS ALSO WHATEVER RECORD KEEPING THE STATE HAS TO DO?

>> I WOULD SAY MODERATELY TO VERY.

NOW, STATES ARE REQUIRED IN STATUTE TO USE ALL AVAILABLE, RELIABLE INFORMATION THAT THEY HAVE.

SO THESE ARE THINGS LIKE INCOME DATA BASES, ADMINISTRATIVE HEALTHCARE RECORDS.

SO STATES WILL BE DOING A LOT OF BEHIND THE SCENES DATA MATCHING SO THEY CAN DETERMINE WHETHER AN INDIVIDUAL IS COMPLIANT OR NOT WITH THIS COMMUNITY ENGAGEMENT POLICY.

THIS MEANS HOPEFULLY INDIVIDUALS WILL NOT HAVE TO DO MUCH ADDITIONAL REPORTING AT ALL.

THINGS LIKE UPLOADING PAY SLIPS TO A WEBSITE OR SUBMITTING MEDICAL RECORDS THAT IS BEST CASE SCENARIO.

NOW, THIS WILL BE BURDENSOME FOR THE STATES THESE SYSTEMS ARE COMPLEX THEY ARE TYPICALLY OLD.

INCORPORATING THESE NEW DATABASE MATCHES IT'S NO SMALL FEAT BUT THIS IS WHAT STATES ARE BUSY WITH RIGHT NOW.

>> Jeff: YOU SEE A DIRECT RELATIONSHIP HOW BURDENSOME THE PAPERWORK REQUIREMENT IS AND HOW MANY PEOPLE WILL LOSE COVERAGE?

>> 100%.

>> Jeff: AND THE STATE HAS A STRONG INCENTIVE TO NOT LET ANYBODY LOSE COVERAGE BECAUSE ANYONE WHO DOES AND THEN WINDS UP IN THE HOSPITAL FOR SOME REASON IT'S PROBABLY GOING TO ADD TO UNCOMPENSATED CARE?

>> EXACTLY.

IN MARYLAND WE HAVE A UNIQUE SYSTEM, EVERYBODY, WHERE WE ALL SHARE THE BURDEN OF UNCOMPENSATED CARE IN SOME WAYS.

YEAH, EXACTLY, BECAUSE HOSPITALS THEY HAVE TO TREAT AND STABILIZE INDIVIDUALS BECAUSE OF FEDERAL LAW, AGAIN.

AND SO THAT'S EXACTLY RIGHT THE WORRY IS FOLKS WILL LOSE COVERAGE BUT THEY WILL STILL GO TO THE HOSPITAL IF THEY NEED CARE THEY ARE NOT GOING TO PAY THEIR BILLS AND THE COMPENSATION WILL RISE AND FURTHER DOWNSTREAM IMPACTS UNFORTUNATELY.

>> Jeff: WE TALK ABOUT THE CONFUSION BETWEEN MEDICAID AND MEDICARE THEY STARTED AT THE SAME TIME AND THEY SOUND SIMILAR BUT THEY ARE DIFFERENT PROGRAMS.

IN MEDICAID, FEWER COPAYS THINGS LIKE THAT.

AND REIMBURSEMENT RATES FOR PHYSICIANS ARE QUITE DIFFERENT, RIGHT?

>> INDEED.

MEDICAID NO COPAYS.

THERE'S NO PATIENT RESPONSIBILITY.

AND AS OPPOSED TO MEDICARE WHICH ALREADY CO--- THERE ARE COPAYS AND PREMIUMS THEY ARE REAL.

TO GENERALIZE I WOULD SAY THOSE REIMBURSEMENTS THAT MEDICAID PAYS TO DOCTORS AND CLINICS AND ALL OTHER STATES HOSPITALS THEY TEND TO BE LOWER THAN WHAT MEDICARE PAYS.

AND SO THIS RESEARCH ON THE EXTENT TO WHICH PROVIDER ACCEPT MEDICAID IT IS A BIG ISSUE IT COMES IN AND OUT OF FAVOR IN THE ACADEMIC LITERATURE BUT THAT IS AN ONGOING CONCERN.

>> Jeff: HOW READY ARE THE STATES FROM WHAT YOU'VE READ WHAT YOU'VE LEARNED?

SPECIFICALLY MARYLAND FOR WHAT IS GOING TO HAPPEN ON JANUARY 1?

>> IT'S DIFFICULT FOR STATES.

EVEN WITHOUT THIS RECENT INTERIM RULE RELEASED ON JUNE 1, IT WOULD HAVE BEEN A SPRINT TO GO FROM THE HR1 SIGNED INTO LAW ON JULY 4TH, 2025 TO GET THINGS SETUP FOR A JANUARY 1, 2027 GO LIVE DATE.

EVEN THAT'S PRETTY TIGHT.

IT WAS DOABLE BUT TIGHT.

RELEASED FEDERAL GUIDANCE HAS CHANGED SIGNIFICANTLY.

SOME OF THE STATUTORY LANGUAGE, I THINK STATES ARE SCRAMBLING RIGHT NOW TO PIVOT AND TRY TO IMPLEMENT THESE CHANGES IN THEIR SYSTEMS AGAIN IN TIME FOR THIS JANUARY 1 GO LIVE.

>> Jeff: YOUR PH.D.

IS IN ECONOMICS?

>> YES, SIR.

>> Jeff: WHEN YOU LOOK AT THE AMERICAN HEALTHCARE SYSTEM AND WE'VE ESTABLISHED A QUARTER OF THE POPULATION IS ON MEDICAID, I DON'T KNOW HOW MANY ON MEDICARE.

YOU HAVE A MIX OF OBAMACARE PLANS, YOU HAVE EMPLOYER PROVIDED HEALTH COVERAGE AND AN INCREASINGLY COMPLEX AND EXPENSIVE SYSTEM COMPARED TO THE REST OF THE WORLD.

THERE IS NO EASY FIX TO GET FROM HERE TO SOMETHING THAT MAKES A LITTLE BIT MORE SENSE, IS THERE?

>> NO.

NO.

SADLY NO.

OUR SYSTEM IS THE WAY IT IS FOR HISTORICAL REASONS.

DECISIONS MADE IN THE 1920s, 30s, 40s THEY ARE WITH US AND DETERMINE THE LANDSCAPE.

I THINK THESE PROGRAMS THAT WERE SETUP 60 YEARS AGO, FEDERAL RULES FROM THE 1970s, AND 80s, THEY HAVE CREATED THESE GRAND FORCES THAT ARE NOW COMPLETELY INTERLOCKING, EXTRAORDINARILY COMPLEX AND IT WILL -- IT'S VERY DIFFICULT TO CHANGE.

I THINK THE HEALTH SYSTEM, IT'S EASY TO BE CRITICAL IN THE U.S.

THE QUALITY OF CARE IS GENERALLY VERY GOOD.

THERE ARE A LOT OF HORROR STORIES OUT THERE.

I'M CONCERNED ABOUT THE RISING PRICES EVERYONE IS RIGHTLY CONCERNED ABOUT THAT.

AND I THINK WE HAVE WORK TO DO.

>> Jeff: BEFORE WE GO, ANY ADVICE FOR SOMEONE WATCHING WHO MAYBE IN THAT GROUP OF MEDICAID PARTICIPANTS WHO WILL BE AFFECTED BY THIS NEW LAW?

SHOULD THEY DO SOMETHING AFFIRMATIVELY NOW?

OR WAIT TO HEAR FROM THE STATE.

>> THEY SHOULD DEFINITELY DO SOMETHING THEY SHOULD CALL THEIR STATE'S MEDICAID AGENCY AND TRY TO TALK TO A HUMAN BEING AND ASK WHAT GROUP THEY ARE IN AND IF THE WORK REQUIREMENTS APPLY TO THEM.

STAY AHEAD OF IT AND THEY SHOULD MAKE SURE THEY HAVE A CORRECT ADDRESS ON FILE BECAUSE THE IMPORTANT STUFF COMES IN THE MAIL.

IF YOU TRY TO GET A PRESCRIPTION FILLED AND YOU DON'T HAVE COVERAGE YOU MIGHT HAVE MISSED A LETTER.

SO MAKE SURE YOU HAVE A CORRECT ADDRESS ON FILE AND KEEP AN EYE ON YOUR MAIL.

>> Jeff: MORGAN HENDERSON AT "THE HILL" AT UMBC WE APPRECIATE YOUR TIME.

THANK YOU VERY MUCH.

AND THAT IS "STATE CIRCLE" FOR THIS WEEK.

JOIN US EVERY WEEK AT THIS TIME FOR THE LATEST ON MARYLAND'S POLITICAL STAGE.

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WE'RE BACK MONDAY WITH "DIRECT CONNECTION" AND YOUR CHANCE TO ASK THE EXPERTS.

THAT IS MONDAY EVENING LIVE AT 7:00 P.M.

FOR ALL OF US AT MPT THANK YOU FOR WATCHING AND WE'LL SEE YOU BACK HERE MONDAY.

[♪♪]