When someone is facing only months to live due to terminal illness, they may consider a physician’s assistance to ease the pain of dying and have more control over what their final moments may look like. But in Maryland, a physician is currently prohibited from participating in so-called “medical aid-in-dying.”

Maryland lawmakers have tried year after year, but so far, no bill to legalize medical aid in dying has passed.

But supporters of the legislation think that 2024 might be the year it passes, due to a changing political climate and overall voter support for the measure. The General Assembly is set to convene Jan. 10.

Del. Joseline Peña-Melnyk, chair of the House Health and Government Operations Committee, said that another round of medical aid in dying legislation will be introduced in the upcoming 2024 session.

“We have been working on it during the interim,” Peña-Melnyk (D-Anne Arundel and Prince George’s) said in a written statement. “I am hoping that this is the year the bill is successful. It has been carefully drafted and thoughtful. I hope the bill is allowed to come to the Senate floor.”

She said that she has asked Del. Terri Hill (D-Howard) to sponsor the House bill next year. Hill could not be reached for comment.

Peña-Melnyk led the previous attempt last year, with House Bill 933, called the “The Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass Act.” The bill would have provided certain medical patients the ability to self-administer medication that would result in their own death.

The 2023 legislation restricted such requests to people with a terminal illness and the mental capacity to make their medical decisions. An individual would initially request aid in dying to a physician and then submit a written request that says they were “of sound mind” and suffering from an illness that “will, more likely than not, result in death within 6 months.”

While medical aid in dying legislation has never quite made it over the finish line in Maryland, 10 other states and Washington, D.C. have passed similar legislation.

Members of the House of Delegates who support the legislation believe that 2024 will be the year it passes. The question remains on whether Maryland’s senators will support the bill.

“Our question has always been on the Senate side,” said Del. Bonnie Cullison (D-Montgomery).

In 2019, the aid in dying legislation came to an end on the Senate floor when one Senator chose not to vote at all, leading to a 23-23 tie vote and the bill’s demise.

In October, Senate President Bill Ferguson (D-Baltimore City) said that he thinks aid-in-dying legislation will be a “a very real conversation this year,” Maryland Matters previously reported.

“I would say it’s probably going to be one of the headline issues to be addressed this year,” he had said at the time. The Senate president’s office did not respond to follow-up questions.

Cullison said she thinks public opinion is more strongly in favor of medical aid-in-dying procedures.

“This is just another way that folks are able to have personal autonomy over their own health care, and so I think that is how the public is perceiving it,” she said.

A Gonzales Research & Media Services‘  poll that was sponsored by the end-of-life care advocacy group Compassion & Choices surveyed 807 Maryland voters in December of 2021 on their attitudes towards aid-in-dying, and found that 69% believe that “a mentally sound adult with an incurable, terminal illness, who only has six months or less to live, should have the legal option of medical aid in dying.”

Those percentages went up to 73% among Democrats and down to 65% among Republicans. Unaffiliated voters supported the measure at 63%.

And Gov. Wes Moore (D) has previously voiced support for aid-in-dying legislation during an interview with The Daily Record when he was governor-elect.

Donna Smith, the D.C. campaign director for Compassion and Choices, an advocacy group that has pushed aid-in-dying legislation across the nation, said that she thinks that we’re in a different climate than in previous years to take serious consideration on aid-in-dying bills.

For one, she said the conversation about aid-in-dying goes hand in hand with discussions of ‘bodily autonomy’ especially after the overturning of Roe v. Wade.

“I think this is a timely discussion, especially as we look at the abortion rights issue, because that’s one of self-autonomy, right?” she said. “That pregnant women should have autonomy over their body. And I think that applies to death and dying as well. Because why would we not give dying people options at the end of life, when the options are so few?”

Cullison agreed.

“I think what it did was it pointed out the concept of personal autonomy and choices,” Cullison said. “There is a natural progression from that discussion to the discussion we’re having about end of life options.”

Smith with Compassion and Choices also said that the COVID pandemic may have led people consider the challenging discussion, as it “put death and dying in the conversation in a way that had not happened before.”

“It has people thinking about what they want their end of life to look like,” Smith said.

“The experience of going through that, we had to talk about death and dying, what that looks like, in a way that we didn’t have to do that before. The conversation was very taboo to even have. Now, it’s less taboo,” she added.

But there are many who oppose the measure all together.

Various religious groups like the Maryland Catholic Conference oppose aid-in-dying legislation because it “seeks to legalize the intentional taking of human life,” according to its website.

According to a Gallup poll from 2018, while 72% of people surveyed said that a physician should be able to medically end a terminally ill patient’s life at the request of the patient, favorability drops among regular church goers.

Of those who attended church weekly, only 37% agreed with medical aid-in-dying. That went up to 69% among those who would attend church nearly weekly or monthly. Of those who never or seldom attended church, 86% supported medical aid in dying.

There are also concerns from some members of the disability community, who worry that aid-in-dying procedures will endanger people with disabilities. The disability group called Not Dead Yet has opposed the Maryland legislation in the past, and say that efforts should be made to improve quality of care for disabled people.

But supporters of the legislation insist the bill will not target individuals with disabilities and has guardrails to ensure that a patient is not being coerced into making a life-ending decision that they do not want to make.

“A small percent of people opt to go through the process,” Smith said. “And an even smaller percentage of people actually get through the process. Understand that we are talking about terminally ill people. And having a disability does not automatically qualify you for the law.”

By Danielle J. Brown

Maryland’s Department of Transportation is facing billions in cuts to address shortfalls that will squeeze operations and construction budgets.

State officials spent the better part of this week briefing lawmakers and local leaders on an 8% across-the-board cut to all the agencies within the Maryland Department of Transportation.

The Department of Transportation, in a statement responding to questions about the cuts and an expected public announcement next week, blamed the troubles on flagging revenues used to support road and transit projects.

“During a period when families are still feeling the effects of inflation, it’s incumbent on state government to take a balanced approach that tightens its belt while still making strategic investments in the future,” the department said in a statement. “The Moore-Miller Administration has been clear about the challenging budget shortfalls facing Maryland that have long been forecasted to take place. The depths of those structural problems only became clearer over time.

“Maintaining a sustainable, balanced budget requires a number of hard choices while still making key investments to grow Maryland’s economy, which is what the upcoming budget aims to accomplish.”

The briefings this week and a more public rollout next week come just as leaders of the state’s 24 major political subdivisions will gather in Cambridge for three days of policy briefings by the Maryland Association of Counties. The three-day conference, named “The Eye of the Storm” was already expected to include discussions of state budget concerns.

Gov. Wes Moore (D) is expected to speak to the group on Thursday.

In August, Moore warned of hard budget decisions on the horizon.

“As much as I want to say ‘yes,’ you’re going to hear some ‘no’s,’” he said during the association’s Ocean City convention.

Moore did not offer details on possible budget cuts, local project vetoes, or other options.

Just a month earlier, legislative budget analysts warned of looming budget deficits.

Members of the General Assembly’s Spending Affordability Committee were told last month that the state faces a structural gap of $322 million in the coming legislative session. The gap continues to grow in fiscal 2026 and 2027 to $376 million and $436 million respectively.

By fiscal 2028, the gap would grow to nearly $1.8 billion followed by a nearly $2.1 billion deficit the following year.

Driving much of the gap in those last two fiscal years are large increases in spending related to implementing the Blueprint for Maryland’s Future education reforms.

Those gaps in the state’s budget and within the Department of Transportation may further hobble Moore’s promise to “rebuild state government” by filling vacant state jobs.

Moore in January vowed to hire 5,000 new employees before the legislature returned in 2024.

As of mid-September, the administration had hired fewer than 1,000, far short of the pace needed to fulfill his promise.

Maryland, as with other states, is struggling to find ways to pay for road and transit projects.

Currently those projects are paid for through the Transportation Trust Fund. The fund is a dedicated pot of money that in part comes from the state motor fuel and vehicle taxes.

The balance of the fund has failed to keep pace with transportation needs.

People are keeping their cars longer, resulting in less revenue from taxes on new car purchases. More fuel-efficient cars and increases in the number of electric and hybrid vehicles reduced the amount of motor fuel taxes collected.

Additionally, the money the state does collect is not going as far as inflation and other factors drive up the cost of projects.

A proposed six-year spending plan known as the Consolidated Transportation Plan, was presented to lawmakers out of balance. It is the first time that has happened in the history of the planning document.

“This was an issue that this administration inherited,” the transportation department said in its statement Friday night. “Maryland has known the current model for funding transportation in the state was unsustainable — coupled with years of flat revenue created the current problems with how the state funds transportation.”

Earlier this year, Transportation Secretary Paul Wiedefeld told a blue-ribbon commission tasked with modernizing how the state pays for roads and transit projects that there is a shortfall of $100 million in the first year.

That shortfall grows to $2.1 billion by the end of the current six-year proposal.

The fund is barely enough to keep pace with state-of-good-repair efforts and previously approved projects. Newer projects including the Red Line east-west project in Baltimore and widening of portions of the Capital Beltway, I-270 and replacement of the American Legion Bridge are not covered.

“The department is reviewing every dollar that it spends to ensure that funds are being invested in a way that meets our priorities,” Wiedefeld said in an email response when asked Thursday if the agency was planning to make any budgetary adjustments.

The initial failure to present a balanced spending plan has irritated lawmakers and local officials.

“MDOT is required to submit the final CTP to the legislature in mid-January, but we expect to provide additional information on what that final CTP will look like in the coming weeks,” Wiedefeld said in his email response.

Over the week, transportation officials met with leaders of the state’s eight largest jurisdictions and state and federal lawmakers to brief them on the coming announcement.

Multiple sources who were familiar with those briefings said the cuts included elimination or reductions in commuter bus service, possible elimination of as many as 10 MTA bus lines considered the least used; cuts to MARC service into West Virginia and a decision to forego a plan to expand train service along the Brunswick line.

Spokespeople for the department did not respond to specific questions about individual cuts nor did they elaborate on briefings given during the week.

“In spite of these strategic budget cuts, the state continues to protect the federal investments, approximately $7 billion in total, dedicated to transportation projects,” the department said in its statement. “The Moore-Miller Administration will continue to propose ideas that are in the best interest of the Maryland taxpayer.”

By Bryan P. Sears

Half a dozen free-range chickens were scratching on a narrow patch of grass at a farm in Potomac Monday afternoon, looking for insects, seeds and other things to eat.

The chickens, with names like Sophia Loren and Marilyn Monroe, seemed happily oblivious to the four cloth chicken dolls stuffed into a cage on the grass before them. But for the humans gathered at Rosie’s Farm Sanctuary, the visual made for a stark tableau.

Several animal rights activists came to the farm Monday to discuss the Humane Society of the United States’ top legislative priority for the upcoming Maryland General Assembly session: a bill that would require all chicken eggs farmed and sold in Maryland come to come from birds who were not cooped up in so-called battery cages.

“These battery cages are incredibly cruel,” said Jennifer Bevan-Dangel, director of the Humane Society’s Maryland office.

State Sen. Karen Lewis Young (D-Frederick) and Del. Jen Terrasa (D-Howard) are preparing legislation that would make Maryland the 11th state to prevent the sale of eggs from chickens who spend their days in battery cages, which are designed to house up to 10 egg-laying hens and are often arrayed in long rows in a chicken coop. If it becomes law, Bevan-Dangel said, the bill would cover roughly 2 million chickens raised in Maryland and another 6 million chickens from out of state whose eggs are sold here.

“This is the most consequential piece of legislation in Maryland for animals, in terms of the number of animals impacted,” she said.

Young, a longtime animal rights activist who helped her father establish a kill-free pet shelter in Lycoming County, Pa., more than three decades ago, introduced the bill in this year’s legislative session, but it failed to get a vote in the Senate Committee on Education, Energy and the Environment, where she serves. Bevan-Dangel said animal rights activists viewed this year’s legislative push as an educational effort but are intensifying the struggle in advance of the 2024 session, including a House sponsor for the first time.

“We’ve always had an ambitious agenda because the legislators have shown they’ve been very supportive of animal rights,” she said.

The setting for the news conference, on a hillside of a rolling 5-acre rescue farm that was set up as a nonprofit about a year and a half ago, was fitting, and friendly, camera-ready sheep and other animals wandered by as the activists were speaking. The timing of the news conference was also not coincidental — coming at the beginning of Thanksgiving week, when millions of Americans are looking forward to eating turkey, chicken, ham and other meat delicacies.

Michele Waldman, who established Rosie’s Sanctuary as a home for dozens of farm animals, said the nonprofit is designed to educate the public about the kinds of animals who are abused in the marketplace. The farm offers tours to school groups, other organizations and individuals who are interested in animal rights. Waldman said she gets daily entreaties to shelter animals that are being abused, but said there are only so many the farm can accommodate.

“As you can see,” she said, gesturing to the chickens, “they just love to forage. They spend half the day doing this.” These particular birds were rescued from an Orthodox Jewish festival of atonement in Brooklyn, N.Y., where they were scheduled to be ritualistically waved over people’s heads and then slaughtered.

Young and Bevan-Dangel said animal rights is only one aspect of the legislation.

“There are health and safety reasons,” Young said. “There’s scientific evidence that caged birds are more likely to produce eggs that produce salmonella and possibly other health hazards.”

“If COVID taught us nothing, it’s that close proximity can be an incubator for disease,” Bevan-Dangel said. She also cast the legislation as a consumer rights bill, noting that the price of cage-free eggs would drop if all the eggs on the market were produced in the same way.

When the bill was up for a hearing earlier this year, the Maryland Farm Bureau opposed it in part on the grounds that the legislation would be too costly. In written testimony, the Farm Bureau estimated that if it became law, the bill would result in a 41% increase in cost of production to retrofit the existing barns and an 119% increase in labor.

“By moving to a cage-free operation, the hen mortality rate increases significantly due to more bacterial habitat being introduced in the barn,” Colby Ferguson, the farm bureau’s government affairs director, said in his testimony. “Lastly, these farms are contracted with out of state companies that will just drop their contracts with the farms and then these farms will have to create a new demand for their eggs in a market where there is already an oversupply of cage-free eggs. This bill would put the few egg-laying farms, that farm this way, out of business.”

Ferguson also offered another reason why farmers objected to the legislation: “We oppose any legislation that would interfere with the right of farmers to raise livestock and poultry in accordance with commonly accepted agricultural practices,” he wrote. “Regulations imposed on agriculture shall be based on economically sound and scientifically proven research to ensure that agriculture, including livestock and poultry industries, remains viable and continues to be a strong economic base for Maryland. All regulations shall be subjected to a rigorous scientifically justifiable cost/benefit analysis.”

Opposition at the hearing also came from the Maryland Rural Council, the Wicomico County government and a few individuals.

Young said she and Terrasa are trying to tweak the language from the previous bill to make it more palatable to the agriculture industry and other opponents. Bevan-Dangel said the bill as originally written would not have outlawed cages altogether or prevented farmers from housing chickens indoors.

By Josh Kurtz

A blue ribbon transportation panel is poised to recommend new fees for electric vehicles and increased tolls as part of an effort to solve a revenue shortage plaguing the state’s Transportation Trust Fund.

The Transportation Revenue and Infrastructure Needs Commission was briefed on both possibilities Monday. An interim report due to the General Assembly by the end of the year could include both recommendations to lawmakers and the Maryland Department of Transportation.

Frank Principe, chair of the panel sometimes called the TRAIN Commission, said the recommendations “are just some of the pieces of the puzzle.”

“There’s clearly some urgency around what needs to be done,” he said in an interview.

The panel will continue to work through 2024 on other related issues including recommendations on improving the process by which state transportation officials select and prioritize projects.

Maryland Transportation Secretary Paul Wiedefeld has crisscrossed the state in recent months highlighting a six-year consolidated transportation plan. The budget document outlines projected spending on transportation projects for the state, counties and the city of Baltimore.

Those projects are paid for through the state’s Transportation Trust Fund — a dedicated pot of money that includes revenues from the state’s current 47-cents per gallon gas tax, new vehicle taxes and the bi-annual vehicle registration fees.

But those revenue sources are struggling to keep pace with growing transportation needs. Motor fuel tax collections are diminishing due to more fuel-efficient vehicles and increased adoption of electric vehicles.

People are also keeping their cars longer, which drives down tax collections on new vehicles.

The state’s current six-year transportation project plan as presented, however, faces a $100 million shortfall in fiscal 2025. At the end of the sixth year of the proposal, that gap grows to $2.1 billion.

The 10-year shortfall is projected to be nearly $4 billion, according to a recent report by legislative budget analysts.

Wiedefeld, in early testimony both before the commission and last week with a legislative panel, stressed that the plan currently doesn’t include new projects such as the Red Line.

“I do want to make the point again, that things that we talked about today are potential pieces to the puzzle, but these ideas alone are not going to solve the fiscal hole that the secretary has spoken so eloquently about in the coming fiscal year,” said Principe. “The Commission won’t be able to solve the problems of this year’s [Consolidated Transportation Plan]. I know that the department is anxious to also share with us and the public what they’re going to do in terms of balancing the current CTP. So that, I expect, will be a forthcoming conversation.”

Wiedefeld and the department are already under growing pressure from lawmakers and some local jurisdictions who are unhappy with the current unbalanced proposal.

This is the first year the agency has ever proposed an unbalanced transportation spending plan.

On Friday, members of the House Appropriations Committee’s Subcommittee on Transportation and Environment expressed frustration over the state of the spending plan. Many questioned when the agency would present a finalized, balanced plan that county leaders and residents could view and comment on.

“Basically, under state law, we need to present you with a balanced budget in January,” Weidefeld told the committee.

Subcommittee Chair Del. Courtney Watson (D-Howard) said Friday that releasing a balanced plan in mid-January would prevent counties and constituents participating in the process.

“If they don’t find out about that until the budget is introduced, that’s not a good process,” said Watson. “That’s not not enough time for them to react to talk to you. I can see it being a complete disaster, in terms of the legislative session. So, we really want those impacts on current projects to be known in December, ASAP, so that individual counties have time to react, citizens have time to comment, and people aren’t caught off guard.”

Watson and others worried Wiedefeld’s timeline would put the onus on the legislature to make decisions on transportation projects.

“We are not the experts in transportation, MDOT is and so we look to you to make the decisions and we will help you make sure that the public is aware of them so that they can provide feedback,” Watson said.

Registration fees on electric, hybrid vehicles on the table

The TRAIN commission’s interim report will be finalized next month.

That report will likely set the stage for debate in the coming session about a fee on electric vehicle registrations in Maryland.

“I think it has to be based on what we heard today,” said Sen. Pamela Beidle (D-Anne Arundel). Beidle, the incoming chair of the Senate Finance Committee, attended her first commission meeting Monday. She replaces Sen. Melony Griffith (D-Prince George’s) who left the Senate to lead the Maryland Hospital Association.

Any new registration fee on electric and hybrid vehicles will need to be passed by the legislature.

More than 137,000 zero emission vehicles, a category that includes battery electric vehicles, are expected on Maryland roads in 2024, according to a study performed by the Maryland Department of Transportation.

By 2031, that number is expected to jump to more than 1.3 million — roughly 26% of the nearly 5.1 million light duty passenger cars and trucks in the state.

The increase coincides with Democratic Gov. Wes Moore’s announcement in March that committed the state to require all new cars sold in the state to be electric vehicles by 2035.

The vehicles are heavier and cause more wear and tear on roads than standard gas-powered vehicles. But currently, owners of electric vehicles do not contribute to the state’s Transportation Trust Fund beyond the initial taxes and vehicle registration.

Sen. Stephen S. Hershey Jr., (R-Upper Shore) said a fee on electric and hybrid vehicles may have some support from Republicans.

“This was a nonstarter for the Hogan administration,” said Hershey. “He was not going to sign a bill that was going to increase fees, even though I think that it could be considered a user fee or a matter of fairness. Those vehicles should be paying some equitable amount as gasoline-fired vehicles. I think it would be something that would be under discussion, but from what I’m hearing, I think you would see bipartisan support.”

The idea is not new. Thirty-three states have imposed some form of fee on both electric or hybrid vehicles or both. Eleven others including Maryland have proposed such fees but have yet to pass them. Just six — Connecticut, Delaware, Massachusetts, Nevada, New York and Rhode Island — have yet to propose or enact such a fee.

The commission’s interim report may not include a recommended fee level.

The national average for electric vehicles is $128. Hybrid vehicle fees on hybrid vehicles run about $63 on average.

Georgia charges the highest fees at $210.87 for either category.

California, which has nearly 880,000 electric and hybrid vehicles on the road, raises the most revenue nearly $64.3 million in 2021. That state charges $108 on an electric vehicle and $11 on a hybrid.

Toll increase proposal could pinch out-of-state drivers

The panel will also consider a recommendation to increase tolls at the state’s nine toll facilities.

In September, Joseph Sagal, then the director of the Maryland Transportation Authority, said the agency that manages the toll facilities was already contemplating increases.

Sagal died unexpectedly on Oct. 26. His funeral was held Monday.

At least two options for toll increases have emerged. The first is a flat increase on all vehicles. Another option is a tiered model where out-of-state drivers may pay more.

The commission was briefed by legislative analysts on the possible effects of a flat rate increase.

Under one scenario, the state could increase revenue by more than $81.4 million by increasing tolls by 50 cents on all vehicles. Revenue would increase by nearly $89 million if the state increased tolls by 25 cents per axel, according to analysts.

Roughly one-third of the 162.8 million transactions at state toll facilities involved out-of-state vehicles.

Imposing a flat 50-cent increase on those vehicles would increase toll revenues by more than $26.7 million. A 25-cent-per-axel increase would boost state toll revenues by nearly $31.6 million on those same vehicles, according to the analysts’ projections.

Currently, money collected from tolls is set aside to pay the bonds issued for projects at Maryland Transportation Authority facilities. The increases could be funneled into the trust fund.

“So, we’ve reached the bad ideas category of this,” said Hershey, adding that the commission should also reconsider farebox collections on mass transit.

“Before we start looking at raising the gas tax, before we start looking at raising tolls, I think that needs to be on the table,” he said.

But other states including New York and Virginia use toll revenues for transportation projects, according to House Environment and Transportation Chair Del. Marc Korman (D-Montgomery).

Maryland already offers a discount on tolls for drivers with an E-ZPASS account registered in Maryland.

The legality of tolls levied on out-of-state drivers is a matter of debate.

In Rhode Island, a federal judge declared unconstitutional a plan to charge tolls to out-of-state truckers while exempting state businesses and cars registered in the state. The state has appealed the ruling and is awaiting a decision by the First Circuit Court of Appeals.

The commission is seeking advice from the Office of the Attorney General.

“We’ve asked the attorney general,” said Principe. “It’s something that’s being pursued.”

By Bryan P. Sears