During the recent special legislative session to address Maryland’s structural deficit, lawmakers increased a variety of taxes so revenue could keep up with projected spending. With future spending obligations being the rationale to raise taxes, it seems sensible that our legislators would take steps to control spending.

Instead, they actually increased eligibility for Medicaid, a program that is already one of the largest in the state budget. At a time when all are concerned about the state’s deficit, this was a short-sighted move.

Medicaid is one of Maryland’s largest budget items, consuming 15 percent of general fund revenues. Moreover, Medicaid spending is growing at a worrisome rate; since 1999, program spending has more than doubled. Around 11 percent of Marylanders receive medical care from Medicaid or the Maryland Children’s Health Program.

One of the main problems with Medicaid is that there are no limits on its growth. As an entitlement program, anyone who qualifies for Medicaid receives it. That means that trying to properly budget Medicaid spending is difficult, if not impossible.

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In fact, looking at the past 15 years of Medicaid spending, the General Assembly has yet to predict accurately how much money to allocate to pay for the next fiscal year’s Medicaid spending. Given the fact that since 1999 the amounts budgeted for Medicaid spending have always been lower than actual expenses, it is likely that the new expansion in the program will cost more than lawmakers predict.

And if the economy slows down, it is likely to cost a lot more. The program’s history shows that when the economy cools, Medicaid spending and enrollment increase. During the recession earlier this decade, spending increased from 10 percent to 14. At the same time, the recession weakened Maryland’s general fund revenues, so that Medicaid was requiring an increasing amount of decreasing revenue.

In 1999 Medicaid consumed 13 percent of General Fund revenue. By 2003, it took up 17 percent, reducing money available for other programs.

Given the historic spending patterns of this program, expanding it in today’s economic and fiscal climate makes little sense. Even with the recent tax increases, it is unclear if the state will have enough revenue to satisfy current spending trends. And it is likely that economic growth will not be very robust in the next few years, while Medicaid’s growth will be substantial. New Medicaid spending will put even more strain on the state’s taxpayers.

In an acknowledgment of the current budget situation, the Medicaid expansion will take place over the next few years and parts of it will supposedly only take place if there is enough revenue to pay for them.

However, once benefits are promised they are difficult to deny. And by pushing the bulk of the expansion’s expenses into future years, legislators are merely replicating the situation that created the current structural deficit.

Instead of making the program larger, our lawmakers should have looked for ways to restructure the program to meet the needs of the poor while protecting taxpayers.

Other states are looking at innovative reforms that try to inject certainty into the Medicaid budgeting process and also give recipients better care. It is unclear how these reforms will fare, but Maryland should examine the actions of these states and see what good ideas could be incorporated here.

One thing is certain, if lawmakers were serious about addressing Maryland’s deficit, expanding Medicaid was exactly the wrong thing to do. Lawmakers meeting in the special session merely added to future deficits by increasing Medicaid spending. Expanding Medicaid instead of reforming it will only cause budget problems for Maryland taxpayers down the road.

Marc Kilmer is a senior fellow at the Maryland Public Policy Institute, a public policy think tank based in Rockville.