What is the greatest health care challenge facing Maryland today, and how do you plan to address it?
Two of our greatest healthcare challenges facing Maryland are substance use disorders and the inadequacy of mental/behavioral health resources. In trying to address substance use disorders, I would support increased opportunities for counseling and behavioral health therapies so that users are not delayed when seeking help, expand Medicaid services for individuals with a substance use disorder, reduce barriers for providers to offer medical assisted therapies, improve access to residential and hospital-based treatment facilities, promote harm reduction policies, and increase resources for recovery coaches and peer supports as well as other methods of long-term recovery care.
The state faces a significant shortage of mental/behavioral health providers and beds. Over the years, I have heard from many concerned constituents who were unable to find a psychiatric bed for a relative of family member in need. I will support state policies addressing disparities between insurance coverage and accessibility of mental and behavioral health services and other forms of healthcare. I will also aim to increase the pipeline of mental health providers and counselors practicing in the state. Finally, I will advocate for additional funding for psychiatric beds and mental health facilities throughout the state.
Maryland’s hospitals operate under a unique contract with the federal government that promotes community, equity, and value. It also contributes significantly to Maryland's economy. How do you plan to support the continued success of the Maryland Model?
I am a strong proponent of Maryland’s Total Cost of Care Model. It is an innovative method of ensuring that all sectors and stakeholders in the healthcare system have an incentive to do what’s right for patients, minimize passing patients off from one facility to another, and help reduce the overall cost of providing healthcare in the state. I applaud hospitals’ willingness to accept and promote this model with the aim of improving the overall health of a community so that individuals can avoid costly hospital care. This has provided the state with tremendous cost savings, reduced admissions and readmissions, and improved the health of our communities. I will support continued efforts to expand the Total Cost of Care Model, to promote greater improvements in population health and equity, and help advance value-based mechanisms.
Maryland is experiencing a shortage of health care practitioners, especially nurses, that we project will worsen in the years ahead. How do you plan to address the immediate crisis and what will you do to make sure we have a robust and sustainable health care workforce pipeline?
I am concerned that the need for healthcare practitioners and nurses will continue to increase with our aging population, and the existing shortage of healthcare workers will only worsen as the pandemic has caused many to exit the workforce. Maryland faces a shortage of providers, particularly primary care physicians, that I believe can be helped by increasing residency training in primary care specialties and through greater loan repayment programs for physicians. The nursing shortage is particularly acute, which is why I agreed to sponsor legislation in 2022 aimed at prohibiting price gouging, which would have limited nurse staffing agencies from pocketing exorbitant profits and further exacerbate the availability of nurses. To increase the nurse pipeline, I also believe it is important to increase capacity within institutions of higher education to help educate more nurses. These institutions need support to address the shortage of nurse educators, inadequate campus facilities and equipment for training, and the lack of clinical placements for student nurses. The state should also provide more support and resources for associates-degree nurses to earn a BSN. This includes consideration of authorizing or initiating more BSN training programs at community colleges, which are often more accessible to historically unprivileged students and less expensive than universities.
In the 2022 legislative session, the Maryland General Assembly passed legislation to establish a Commission to Study the Healthcare Workforce Crisis in Maryland. I look forward to the Commission’s findings and recommendations and would be willing to sponsor legislation that aims to implement the report’s conclusions.
How would you increase availability of and access to health care for Marylanders?
Availability and access to healthcare is a priority for all Marylanders. I would aim to sustain parity in provider reimbursement for Medicaid and Medicare patients, parity in resources and compensation for mental and behavioral health services, innovatively expand Medicaid coverage to support greater services and programs, and facilitate greater use of telehealth to reduce disparities and access to care in more rural and distant parts of the state.
What policies will you pursue to improve health for all Marylanders? Please also consider the social determinants of health?
As a preventive medicine physician and as the only physician in the Senate of Maryland, I recognize the importance of considering the various social determinants of health and their influence on population health. That is why—over the past eight years in the legislature—I have sought to pursue policies and legislation aimed at improving access to effective, high-quality care for patients across the state, especially marginalized or underserved populations. This legislation includes increasing access to PReP/PEP for those individuals with HIV, increasing access to pre/perinatal care for undocumented mothers and babies (the Healthy Babies Equity Act of 2022), allowing pharmacists to provide injectable antibiotics for patients with STDs, methods of increasing federal compensation for those who are uninsured (Access to Care Act of 2022), permitting a special enrollment period for pregnant women who are uninsured, expanding access to doulas, and making it easier for individuals to access opioid overdose drugs and services. If I am reelected to the Senate of Maryland, I will continue to champion policies that address the state’s population health needs and comprehensively address our social determinants of health.
How do you plan to address consumers' growing exposure to health care costs, such as high deductible health plans and rising prescription drug prices in Maryland?
I will aim to reduce consumers’ risks and unpredictability when it comes to high deductible health plans (HDHPs) by striving to introduce or support legislation that a) reduces impediments to seeking or delaying medically necessary care due to the lack of resources or inability to meet their deductible, b) decreases instances of medical debt which can negatively affect an individual’s physical and mental health, c) makes it easier for consumers to budget their annual healthcare costs through reduced complexity in HDHPs’ cost sharing mechanisms and pricing opacity, and d) improves healthcare literacy among consumers in order to better understand these HDHPs and select the best and most appropriate plan for them.
Rising prescription drug prices continues to be an issue in Maryland, and it is a concern that I have heard from many constituents, especially older individuals on fixed incomes. I will strive to support legislation that will strength prescription drug price transparency provisions, enact stricter oversight and regulation of pharmacy benefit managers, leverage interstate drug purchasing pools to maximize purchasing power, and cap consumer prescription out-of-pocket costs through limits on drugs like epinephrine and asthma inhalers. (I was the sponsor of legislation that passed in 2022 that limited the cost of insulin to no more than $1 per day.) Maryland also has a Prescription Drug Affordability Commission that is working on issuing recommendations to address rising consumer costs, and I look forward to their report as a starting point to advance further protections for consumer out-of-pocket drug costs.
Maryland’s worsening medical liability climate, as noted in a recent independent report, threatens access to, and affordability of, health care services in Maryland. Plaintiffs’ attorneys typically take 40% of a medical malpractice judgment. Do you support limiting attorneys’ fees so that the affected individuals can receive more of their settlement or judgment? What additional reforms would you support that balance supporting individuals and families harmed by medical malpractice with ensuring continued access to services in a community?
I support limiting attorney’s fees so that affected individuals can receive more of their settlement or judgment. I would also support additional reforms, including: a) a limitation on noneconomic damages in medical liability cases, b) collateral source payments in medical liability cases, c) greater regulation of expert witnesses in medical injury actions, and d) periodic payments of awards for future damages.
What are your priorities should you be elected, not confined to health care?
I am running for reelection to the State Senate in order to continue addressing the priorities of our constituents and tackling the challenges facing our state in an equitable, fair, and forward-looking manner. Over the past four years, I’ve worked hard to improve our schools, develop job opportunities, foster economic development, ensure fair wages and protections for working families, expand access to healthcare, safeguard our environment, enact criminal justice reform, bolster mass transit and transportation projects, and reduce discrimination and injustices against minority or marginalized populations. But while we’ve made significant progress on these issues, much work remains, and I am seeking to return to the legislature in order to advance these ongoing efforts even further.