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Did the recent senatorial election in Massachusetts alter the landscape for health care reform? Those who believe that should take a close look at what the future looks like without comprehensive reform. While Scott Brown represents a state that has enacted reforms so that almost 98 percent of its population is insured, the rest of the country, including Maryland, is not so fortunate.

A March 2009 report from Families USA cited statistics showing that more than one in four Marylanders under the age of 65 went without health insurance for all or part of 2007 and 2008. That is 29.1 percent of our residents. At the same time, 430 people become unemployed every day in Maryland, and 230 lose their health insurance.

For others, the rise in insurance premiums has put the squeeze on household budgets. From 2000 to 2007, health insurance premiums for working families increased by 64.1 percent. So, even if you are not one of the almost 65.7 million people that the Robert Wood Johnson Foundation estimates will be uninsured in a decade, you can expect your costs to skyrocket without health care reform.

What happens when you don't have health insurance? In 2006, an estimated 450 people died in Maryland due to a lack of health insurance — more than one person a day. Others suffer with curable diseases because they can't afford to see a doctor. And, that assumes that doctors are available. Garrett County has no ob-gyns, and Kent County has been designated by the federal government as a severe shortage area for health professionals.

We simply cannot afford to do nothing. The legislation passed by the Senate and House would cover from 31 million to 36 million people, respectively, bring needed reform to the private insurance market, close the Medicare Part D doughnut hole, expand the health care work force and bring down costs over the long term.

The Maryland Women's Coalition for Health Care Reform commends the members of our state's congressional delegation, who have taken leadership roles in this legislative process. But, we still do not have a final bill for President Barack Obama to sign. So, they cannot stop now. Maryland's residents want reform, they want it right, and they want it now.

The Maryland Women's Coalition for Health Care Reform also recognizes that our state cannot wait for federal reform. We commend the president for including critical funding in his 2011 budget that includes the allocation of much-needed dollars for health centers that provide essential preventive care and services to our underserved populations, as well as investing in the National Health Service Corps to bring primary care professionals to rural communities.

The Maryland General Assembly also must act, even in the face of our budget deficit. A first step would be to support an increase in the alcohol tax to fund the expansion of Medicaid to childless adults up to 116 percent of the federal poverty level, which was passed in the 2007 special session. And, we must be certain that there are no more cuts to the budgets of our local health departments — a critical lifeline for many of our state's most at-risk residents.

It is time for Maryland's elected officials to understand that access to comprehensive, high-quality and affordable health care for all residents of our state is a fiscal, physical and moral imperative and that delay or inaction is unacceptable to their constituents.

Anne S. Kasper is chairwoman and Leni Preston is vice chairwoman of the Maryland Women's Coalition for Health Care Reform.