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BALTIMORE — No matter who wins the presidential race in November, a national debate on health care is sure to start in 2009, Del. Heather Mizeur said Tuesday.

"It will be a different kind of debate depending on who wins. It seems like every 10 to 15 years we're ready to take this national health care debate on again," said Mizeur (D-Dist. 20) of Takoma Park.

Maryland took its own step in expanding health care during the 2007 special session, providing eligibility to Medicaid to parents making less than 116 percent of federal poverty guidelines, or up to $20,500 for a family of three.

On Tuesday, Gov. Martin O'Malley, Mizeur and other elected officials, health care advocates and members of the Baltimore Ravens unveiled a new advertising campaign aimed at getting more Baltimore city residents enrolled in the Medicaid expansion, which went into effect in July.

The program aims to extend health care insurance to 100,000 Marylanders. Going beyond that could depend on the federal government, Mizeur said.

"This is kind of a planning year already," she said.

The ad campaign, which will cost $150,000, includes radio spots featuring O'Malley and Ravens safety Ed Reed, who encourage city residents to call 311 to learn more about coverage eligibility. They will air on five Baltimore radio stations.

Twenty-six billboards around the city, as well as posters on buses and at bus shelters will feature Ravens players and encourage residents to call or go to www.bhca.org to get enrolled.

Residents outside of Baltimore can go to www.dhmh.state.md.us/gethealthcare.

The General Assembly passed the expansion when lawmakers enacted a series of taxes to close a $1.5 billion budget gap.

Despite the state's budget crunch, expanding Medicaid coverage was "the right thing to do," said O'Malley (D), who spoke outside Paul's Place, a soup kitchen and community outreach center in the Pigtown/Washington Village neighborhood where many residents lack health care.

The expansion will save all Marylanders money by decreasing the cost of uncompensated care of uninsured people that those with insurance pay as part of their premiums, the governor said.

"We spend and waste so much money because working people do not have health care coverage so they can get the preventive care," he said. "And as a result, guess who pays? We all pay when people have to become so sick, when their children have to become so sick that they have to be hospitalized."

The expansion will take Maryland from 44th to 21st in the nation in insuring adults.

The state has already enrolled 11,283 people in the expansion since it took effect July 1, including 2,945 Baltimore city residents.

Letters were mailed to 10,000 eligible families Monday.

The expansion package also included $15 million in subsidies for businesses with two to nine employees whose wages are below $50,000 a year to provide coverage.

Nearly 800,000 Marylanders lack health coverage. The next — and more difficult — step toward reducing that number is phasing in eligibility to childless adults between fiscal 2010 and fiscal 2013.

With the economy in a tailspin and the General Assembly facing a projected $1 billion deficit by fiscal 2010, some have said it could be too big of a step.

In July, Senate Finance Chairman Thomas McLain Middleton (D-Dist. 28) of Waldorf said the expansion to childless adults could not happen unless the state voted to legalize slot machine gambling.

The state is looking at public-private partnerships with providers such as CareFirst, but the state's best chance at further expansion could be taking advantage of federal dollars.

The federal government offers a dollar-for-dollar match on state investments in Medicaid and a 65-30 federal-state split on funding for the Maryland Children's Health Insurance Program.

"We would be pulling down more money than we would be spending," Mizeur said.