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Don't burden the states with the cost of expanding Medicaid, Gov. Martin O'Malley said Friday after a speech to health care executives and labor leaders in Silver Spring.

When it comes to growing Medicaid, the governors at the National Governors Association in Biloxi, Miss., last week favor the House version of a health care reform plan making its way through Congress, The New York Times reported.

Under the House plan, the cost of expanding Medicaid to low-income families not covered by Medicare would be picked up by the federal government. Under a bill considered in the Senate Finance Committee, the federal government would pick up the bill for several years, before states would have to pay their usual share — an average of 43 percent of the cost.

Freeing states from that burden would be a "critically important part of the ultimate solution," O'Malley (D) said during a day-long health care forum at the Kaiser Permanente Health Care Institute at the National Labor College.

"With how many states are taking on water, to add costs to them in these times would make it difficult, if not impossible," he said.

While O'Malley and others are pressing for a national solution, "That does not absolve us in Maryland from rolling up our sleeves to extend more health care benefits to more people, better coverage to more people," he told forum attendees.

Under legislation passed during the 2007 special session of the General Assembly, the state has expanded Medicaid coverage to more than 44,000 people. About 15,000 more are eligible, but not enrolled, advocates estimate.

The expansion also has allowed 200 small businesses to extend coverage to their employees. As many as 10,000 Marylanders could be covered under the small business subsidy, O'Malley said. The small business expansion has been slow, as business owners are reluctant to enroll for coverage, fearing they could be left to pick up the cost of benefits if the state were to cut the subsidy.

Recent legislation also has increased incentives for dentists to provide care to children and addressed the so-called doughnut hole gap in Medicare prescription drug coverage, O'Malley said.

Maryland is also the first state to develop a statewide biosurveillance system, known as ESSENCE, which links 46 hospitals and allows real-time monitoring of symptoms reported in emergency rooms. The system enables doctors to better identify epidemiological trends.

The first outbreak of the swine flu this spring gave the state a chance to fine-tune the system, O'Malley said.

State health and education officials met in Annapolis on Monday to discuss preparations for addressing the swine flu pandemic during the upcoming school year. A stronger strain of the virus is expected in the fall.

Spurred by legislation passed this year, the state also is building a health information technology system that connects physicians, hospitals, medical laboratories and pharmacies. The law also requires payers to provide incentives for physicians to develop electronic health records and enacts penalties for those who do not adopt the electronic records by 2015.

The federal stimulus package provides $34 billion for expanding the use of health information technology, which was a focus of Friday's forum.

Health IT must be used to pursue prevention, to make patient information available at every step of patient care, to increase the use of online tools and to improve patient safety and reduce medical errors, said Dr. Robert Pearl, executive director and CEO of The Permanente Medical Group, the nation's largest medical group.

"If we want to solve the problems of the 21st century, we have to use the tools of the 21st century," Pearl said.