Vincent DeMarco is president of the Maryland Citizen’s Health Initiative, a coalition of more than 1,000 organizations that seek to ensure quality, affordable health care for all Marylanders. The initiative was the lead organization working for Gov. Martin O’Malley’s Working Families & Small Business Health Care Coverage Act of 2007, which resulted in more than 300,000 uninsured Marylanders receiving coverage.
DeMarco is the National Coordinator of Faiths United to Prevent Gun Violence, Faiths United to End Childhood Obesity and Faith United Against Tobacco; and is also an adjunct assistant professor at The Johns Hopkins Bloomberg School of Public Health. His work is the subject of a book by national advocacy leader Michael Pertschuk, entitled The DeMarco Factor: Transforming Public Will Into Political Power.
DeMarco was previously executive director of a two-year project, the Maryland Children’s Initiative, that brought together more than 350 organizations in Maryland to successfully promote an increase in the state cigarette tax.
Other career stops included stints as the director of community outreach for Handgun Control Inc., and as an assistant attorney general for the state of Maryland. In addition, while advising the Home Improvement Commission, he helped to draft and lobby for enactment of the Home Improvement Guaranty Fund, which compensates homeowners for losses caused by contractors’ poor or incomplete work.
DeMarco received a B.A. in Political Science and an M.A. in American History from The Johns Hopkins University. He also received a J.D. from Columbia Law School, where he was an editor of the Columbia Law Review.
What is your organization hoping to accomplish during this year’s legislative session?
We have three goals. First, we want to make sure that the Federal Affordable Care Act (ACA, or “Obamacare”) is fully implemented in Maryland. We’re ahead of the curve here because we have created a terrific Health Care Exchange Board (HCEB) under [Maryland Department of Health and Mental Hygiene Secretary] Joshua Sharfstein. We will be working with the O’Malley administration to enact strong legislation to give the board the power it needs.
The second goal is to make sure that the money from last year’s alcohol tax increase is used for health care purposes. The governor has proposed doing so in his budget and we will work to get that confirmed by the legislators. The alcohol tax increase was a tremendous public health victory for the state that will reduce underage drinking and alcohol abuse.
Lastly, we want to increase the tax from 15% to 70% on cigars and smokeless tobacco to reduce the underage usage of those deadly products. We’re feeling good about it being enacted because it’s already in Gov. O’Malley’s budget and had strong popular support.
How much money will the state generate if the tax on cigars and smokeless tobacco is increased from 15% to 70%?
The state estimates that $19 million will come in; we estimate $30 million, for both products. And note that the Maryland Comptroller’s office, from fiscal 2001 to fiscal 2011, estimated the total number of cigarette packs sold in Maryland declined by approximately 33.6%; but during the same period, sales of cigar products increased by more than 17.6%.
What’s the latest on the cigarette tax?
We’ve increased it three times during the past dozen years — in 1999, 2002 and 2007. All told, that has resulted in a 32% drop in Maryland’s smoking rate (double the national average) and has saved an estimated 70,000 people, which is double the national average.
However, while there has been a drop in use of cigarettes, the use of cigars by kids has gone up partly because we have not yet increased the tax on cigars and smokeless tobacco. We’re also fighting the use of flavored products, some of which are designed to appeal to new and younger users. We think the proposed tax will reduce the use of those products by 34%.
What is your opinion of the Healthy Howard program?
It’s terrific, and it’s really done a great job in expanding health care to Howard County’s citizens by getting the message out about the ACA, and getting people enrolled using all of the public and private insurance products that are available to citizens who need insurance. [Howard County Executive] Ken Ulman and [Howard County Health Officer] Peter Beilenson should be praised for the great work that they’ve done.
What can citizens do to help themselves in regard to their health care insurance?
I encourage people to go to our web site, www.healthcareforall.com, and the governor’s site for the Maryland Health Reform Coordinating Council (www.dhmh.state.md.us/healthreform). They both have a great deal of information that may prove helpful to our citizens.
Another good site is that of the Maryland Health Care Commission (http://mhcc.maryland.gov), which has a great deal of information about insurance companies and what they have to offer. People often do not understand what’s available to help them, such as the Medicaid expansion of 2007.
In fact, Maryland has gone from 44th to 14th in the county in health care eligibility for lower-income citizens. Gov. O’Malley did a great deal to make that happen and it was partly funded by the aforementioned boost in the tobacco tax.
Are you in favor of giving discounts on insurance for people/businesses that make an effort to stay healthy?
We will leave those kinds of changes to the HCEB because we want them to have the authority to encourage those kinds of updates in the business community.
What is your opinion of the ACA? Did you read the entire (approximately) 1,400-page report?
No. While very few people read the ACA document, it’s been historic and a tremendous benefit for Americans. It has already resulted in many young people staying on their parents’ health care coverage up to the age of 26 and has also provided substantial tax credits for small businesses.
During the next few years, it will provide health care for 30 million Americans as it makes health care more affordable.
What does the general public not understand about the ACA?
Unfortunately, many Americas know very little about what is in the ACA and have some harmful misconceptions. It is not “government run” health care; it is a smart plan to expand health care to more than 30 million Americans and make it more affordable for all of us by, for example, allowing young people to stay on their parents’ health care up to age 26 and creating state health care exchanges. That will increase the bargaining power of small businesses and individuals so they can keep their premiums down.
Does your teaching at Hopkins’ Bloomberg School inspire you as to what can happen to improve the state’s (and nation’s) health care industry?
Yes. And I feel optimistic that the American people will reaffirm their support for the ACA once they understand more about it.
Do you think we’ll eventually see more of an open market for health care providers in Maryland or is the stranglehold of CareFirst BlueCross BlueShield, Coventry Health Care and United Healthcare too tough for other providers to break?
CareFirst has made great progress under [CEO] Chet Burrell. We have to keep an eye on them, like all insurance companies, but they are doing a lot of great things for Maryland. They include helping to make prescription drugs less expensive for Maryland seniors and pioneering ways to make health care coverage more affordable for all of us.
What can you say about the reaction you’ve received in recent years from the alcohol, tobacco and insurance industries?
The alcohol and tobacco lobbies fight hard against our measures, but we have built a powerful coalition that overcomes their opposition.
What are you the most intent about accomplishing at this point in your career?
The full implemention of the ACA. For that to happen, we need to pass the legislation that the O’Malley-Brown administration has introduced to give the newly-created HCEB the authority it needs to make health care more affordable for all of us.
Luckily, here in Maryland, we have a governor, a lieutenant governor and a health secretary who are committed to doing this right. Believe me, I have colleagues in other states that are jealous of our position because their governors are going in the wrong direction.
I recently introduced Gov. O’Malley at a speaking engagement at a Families USA national meeting in Washington, D.C., and his address was very well-received — because the people in the audience were thrilled that, at least in Maryland, the governor was going in the right direction.
