The state of health care in the United States has been rapidly deteriorating on President Bush's watch. The ranks of the uninsured have swelled by 7 million Americans, insurance premiums have risen at four times the rate of inflation, and deductibles have grown 87 percent. In the absence of a federal solution, states and communities are stepping up and offering ambitious plans to address our shared goals of expanding access, reducing costs, and improving quality.

In Maryland, Governor Martin O'Malley announced a proposal yesterday to extend medical coverage to 100,000 additional Marylanders -- a prudent and necessary step towards health care coverage for all citizens.

"Right now, in Maryland there are almost 800,000 people living without health insurance. In many cases, health care is too expensive and out of reach for Maryland families, and when it is available health care quality is not what it should be. We can and must do better," said Gov. O'Malley.

O'Malley's proposal will help address the two major categories of uninsured: adults living in poverty and employees of small businesses. Surprisingly, impoverished adults are often left out of the nation's health care program for the poor. Medicaid has strict requirements for covering poor children and pregnant woman, but not parents and childless adults. O'Malley's proposal will phase-in coverage for these adults as the state can afford it.

In addition, O'Malley's proposal will provide assistance to very small businesses (2 to 9 employees) that do not offer coverage today or are struggling to afford it. O'Malley has looked closely at what works in other states, including Montana, and crafted a policy based on what will work best for Maryland.

Another key feature in O'Malley's proposal is a wellness benefit for small businesses. It will offer lower out-of-pocket costs to employees who take personal responsibility for their health and help lower health care costs.

As several states are doing across the country, Gov. O'Malley is finding ways to cover the uninsured in his state while also being fiscally responsible. Right now, Maryland faces a budget deficit and O'Malley has made it clear that those fiscal challenges must be met. He deserves a lot of credit for addressing the lack of affordable health insurance at the same time.

The Gov's proposal is a first key step along the path to covering all Americans. Maryland and many other states throughout the country are defining a distinctly American approach to universal health care.

As DLC founder Al From said: "Notable about this proposal is that it is not Canadian-style, single-payer health care. It provides more adults with health care coverage that they can afford. In the absence of real leadership from Washington on this issue, New Democrats like Governor O'Malley are tackling health care head on."