By Sam Kinch

As a military veteran, I know how difficult it can be to exercise the basic right to vote when you’re stationed overseas. Military service is an apolitical act, and voting is the only voice we have in the decisions that impact our lives. But too many military members stationed away from home do not vote because it’s too difficult.

Barriers to voting exist not only for our troops, but for disabled people, citizens living abroad, people displaced by natural disasters, young people and marginalized communities. And there are new, unprecedented challenges. WIll natural disasters or weather events prevent planned transportation to vote?” Will new US Postal Service postmarking rules mean that timely ballots are not counted?

There is a solution. Right now, the Maryland legislature is considering legislation that would allow cities to offer mobile voting in municipal elections, in addition to other forms of voting, if they choose to do so. SB727/HB1066, sponsored by Senator Karen Lewis Young and Delegate Mary Lehman, would enable communities to opt-in to pilot mobile voting technology in their local elections if they are interested in doing so.

Mobile voting is not a new concept. Juneau and Anchorage offered this option to voters in their city elections last year. It has been piloted in 21 jurisdictions in 7states (both red and blue) since 2018 and the results were positive. Turnout doubled among military and overseas voters in Denver, and tripled in a special district in Seattle, Washington. In South Carolina, ballot returns among military and overseas voters went from 9.8% in the June 2020 primary to 55% August. And the streamlined process saved more than 70 hours of manual work.

When I was first introduced to mobile voting, I approached it with exactly the level of skepticism you would expect from someone who worked closely with Cyber Command and the National Security Agency. My professional career has been spent both breaking into systems and defending them. I do not take election security lightly, and I would not lend my support to any system that failed to meet a high technical and security bar.

After examining the technology closely—particularly systems that rely on open-source software, end-to-end verification, and independent security review—I believe mobile voting can be implemented responsibly and securely. In fact, I believe it has the potential to solve a problem I have witnessed and lived with for years: eligible voters, especially those in the military, being functionally excluded by distance, deployment, or access constraints.

Based on my experience defending critical systems and assessing real-world threats, I believe that—with the right safeguards—mobile voting can expand access while protecting the integrity of our elections.

Too many Marylanders are excluded from our democracy because voting is not accessible. SB727/HB1066 can begin to move us into a future where all of our community members have the ability to impact the decisions that affect their lives.

Sam Kinch is a resident of Crownsville, Maryland. He spent 30 years in the United States military, including leading the integration of all National Guard cybersecurity forces into U.S. Cyber Command.

By John Blaze

In these challenging economic times, Maryland stands at a critical juncture. Business growth and competitiveness are critical to shoring up the state’s edge as a destination for economic success. With a thriving tech ecosystem, world-class research institutions, and a diverse, highly educated workforce, Maryland has the potential to become a leader in innovation. That is why it is so critical that we seize the moment and support policies and people that will foster our prosperity and ensure Maryland is an attractive destination for prospective businesses and entrepreneurs to call home.

However, potential alone isn’t enough. Now, more than ever, Maryland needs forward-thinking policies that enhance our competitiveness and put us in a strong position to thrive in today’s technological revolution. The recent loss of our triple-A bond rating should be a wake-up call for everyone involved in Maryland’s business and economic landscape. For the first time since 1973, Maryland failed to receive an AAA bond rating from Moody’s, a downgrade “driven by economic and financial underperformance compared to AAA-rated states.” Beyond the direct financial implications, this downgrade is a clear warning that the state is becoming less desirable to new businesses, forcing investors to look at neighboring competitors like Virginia and Delaware.

On top of the downgraded bond rating, which could soon drive business opportunities out of the state and into new markets, we have a “nation-leading” privacy law going into effect soon that will no doubt hamstring small businesses and worsen our competitiveness as a state. The Maryland Online Data Privacy Act (MODPA) of 2024, which jeopardizes small business success, forcing local business owners to navigate complex requirements in order to maintain access to key digital tools, will go into effect in October. We missed a key opportunity this past session to pass a small but important adjustment to the law that would have protected small businesses from burdensome regulations and increased compliance costs.

Persistent regulatory hurdles and outdated infrastructure compound these challenges, undermining confidence in Maryland’s business climate and economic viability. Left unaddressed, these setbacks risk eroding the state’s hard-earned reputation as a destination for commerce and long-term investment. If we want to remain a national leader in technology and economic development, we must recommit policies that build a stable and business-friendly environment, removing avoidable hurdles and signaling that Maryland is ready to lead again

Having been in the supply chain of the semiconductor industry, I know the need to safeguard personal data in an increasingly digital world is critical, but it must be done in a way that supports innovation and does not place unnecessary burdens on those working to build and sustain our economy. At a time when Maryland’s economic vitality is on the line, we cannot afford to impose added economic hardship on our small businesses or the communities they serve. Times are tough. If we become known as a state that supports stringent regulations that hamstring our financial and economic wellbeing, our state risks losing out on prospective business and entrepreneurs who have a lot to offer our state.

The loss of our triple-A rating and failure to pass sensible data privacy protections are just two examples from the growing list of hits Marylanders have taken in the past year. If we want to remain competitive with our neighboring states – as well as states across the nation – we have to do better. Keeping Maryland competitive in today’s digital economy means advancing policies that support innovation while strengthening consumers’ trust. Maryland has the potential to become a national leader in emerging industries, but we must take action to ensure we are providing a competitive landscape that appeals to businesses looking to set up shop. Together, we can position Maryland as a destination for AI companies, entrepreneurs, and investors looking for a strong foundation to build the future.

 

John Blaze, President of Eastern Scientific, a manufacturer’s representative/ distributor company serving semiconductor, solar, optical, and industrial vacuum industries including universities and R & D.

By Marc King

On October 7^th we were introduced to the following press release from the Maryland Energy Administration: Maryland School Districts Eligible for New Grants for Less-Polluting, Money-Saving Electric School Buses – $4.9 million effort to help districts cut long-term operations and maintenance budgets, while improving kids’ health … but is that accurate.

Here is what we know about electric vs. diesel school buses. Electric buses (EVs) have significantly higher purchase prices than diesel buses, which are often 2-3 times more expensive due to costly lithium-ion batteries and electric drivetrains. For example, a typical diesel transit bus costs around $400,000-$500,000, while an equivalent electric model can exceed $800,000-$1 million.

Limited Range and Operational Range Anxiety – EVs typically offer 150-250 miles per charge under ideal conditions, but real-world factors like heavy loads, cold weather, and frequent stops reduce this to 100-200 miles—insufficient for long rural or intercity routes where diesel buses can travel 400-600 miles on a single tank. Recharging infrastructure gaps exacerbate this, leading to downtime and the need for route redesigns, as highlighted in studies by the International Council on Clean Transportation (ICCT).

Long Charging Times and Infrastructure Demands – Recharging takes 2-8 hours (or longer without fast chargers), compared to diesel refueling in minutes. This requires extensive depot upgrades, high-capacity chargers, and grid reinforcements, which can cost millions and strain urban electrical systems. Diesel buses avoid these issues with ubiquitous fueling stations. The World Resources Institute points out that inadequate grid capacity in many regions leads to charging delays, reducing fleet utilization.

Battery Degradation and Replacement Expenses – Batteries degrade over 5-10 years, losing 20-30% capacity, necessitating replacements costing $200,000-$500,000 per bus. Diesel engines, while requiring maintenance, have longer overall lifespans (up to 500,000 miles) with cheaper part replacements. Extreme temperatures accelerate EV battery wear, according to data from the Electric Power Research Institute (EPRI).

Dependency on Electricity Grid and Supply Chain Risks – EVs rely on stable, clean electricity; in regions with coal-heavy grids, they may not reduce emissions as expected during charging. Supply chain vulnerabilities for rare earth minerals (e.g., lithium, cobalt) cause price volatility and delays, as seen in 2022-2023 shortages. Diesel fuel is more readily available nationally and locally without such dependencies.

Weight and Performance Trade-offs – Heavier batteries (up to 10,000 lbs.) reduce payload capacity and increase tire/brake wear, potentially raising maintenance costs. Diesel buses are lighter and offer instant torque but better hill-climbing without range penalties in varied terrains.

Total Cost of Ownership Uncertainty – While EVs promise lower fuel and maintenance savings (no oil changes, fewer moving parts), these are offset by high initial costs and battery issues, making TCO comparable or higher over 12 years in some scenarios.

Maryland needs to stop being distracted by the Green New Deal and stick to affordable solutions for our school bus fleets.

 

Marc A. King was a 2018 Republican nominee for delegate in the Maryland Legislature from Legislative District 15. Marc has continued his political activism by providing blogs related to a variety of political activities at the federal, state and local level. A retired Army lieutenant colonel, he transitioned from the position of President, Ceradyne Armor Systems, Inc., and provides advice and assistance to defense contractors as the President and CEO of KGV Enterprises, LLC, a defense strategies consultancy.

By Clayton A. Mitchell, Sr.

I have been consistently critical of Baltimore’s leadership over the years—and often with good reason. The city has faced more than its fair share of dysfunction, with public safety, government accountability, and basic quality of life all suffering as a result. However, fairness demands that when things begin to improve, we acknowledge that fact, even when progress comes from a leader we did not expect.

Mayor Brandon Scott delivered his State of the City address recently with a message that was not only hopeful—it was backed by real, measurable results. Since 2020, homicides in Baltimore are down 40 percent. Shootings are down 43 percent. Robberies, carjackings, and auto thefts are all down by significant margins. That is not political spin. That is a real change.

Mayor Scott credits this progress to Baltimore’s Comprehensive Violence Prevention Plan—a combination of law enforcement coordination, community outreach, and investment in long-neglected neighborhoods. Whether one is a skeptic of such programs or a strong believer in them, it is difficult to argue with the outcome.

To be clear, I am not offering a blanket endorsement of the Scott administration. I have questioned his priorities in the past, and I likely will again. However, when a mayor presides over one of the most significant drops in violent crime in recent memory, it is only right to acknowledge the achievement.

What is also clear is that this is not the same Brandon Scott who took office in 2020. In many ways, we are seeing the emergence of Mayor Scott 2.0 – a leader who has grown into the job through trial, error, and, most importantly, experience. The early days of his administration were marked by lofty rhetoric and an unproven governing philosophy. But over time, he has shown a willingness to adapt, to test new approaches, and to learn from what works and what does not.

That evolution deserves recognition. There is a steadier hand on the wheel now, one more focused on outcomes than ideology. Scott’s tone in his address reflected that growth—not triumphant but measured and committed. “This is progress, but we have more work to do,” he said, reaffirming a goal of reducing homicides by at least 15 percent each year. That kind of realism is welcome, especially in a city where leaders have too often substituted slogans for serious solutions.

And while I may not be inclined to adopt phrases such as “Baltimore is built different,” I understand what the mayor meant. This is a city with grit, pride, and residents who have not given up—even when their government appeared to have done so.

So yes, I give credit where it is due. Mayor Scott has helped bring about a meaningful reduction in violent crime in Baltimore. That deserves recognition. If he remains focused, avoids distractions, and continues to lead with a results-driven mindset, there is no reason that this progress cannot continue.

We will continue to hold him accountable—as we should. But we must also be willing to acknowledge when something is working. And at this moment, on crime, something in Baltimore clearly is.

Clayton A. Mitchell, Sr. is an attorney who resides on the Eastern Shore and is co-host of the Gonzales/Mitchell Show podcast.

by Zafar Shah

Sandra is still homeless.¹  She had to put her daughter in a friend’s care and live in her car. Nearly a year ago, she reached out to Maryland Legal Aid after her lease in Easton wasn’t renewed. The property manager told her she was being “uncooperative or argumentative,” but legally, no reason was required. Maryland is a “no cause” state, meaning landlords can refuse to renew a lease without justification. For Sandra and her daughter, that meant exile from their home and community.

After months of searching, Sandra kept hitting dead ends. Properties that accepted Section 8 vouchers were controlled by the same management that wanted her out. Other landlords required an income three times the rent. Maryland Legal Aid helped extend her housing voucher, but even in nearby counties, she couldn’t find a place. Her life unraveled. With no legal protection, we could only advise her to call the 988 Suicide and Crisis hotline.

Sandra’s story is not unique. For over 15 years, renters and advocates have pushed for Good Cause Eviction protections, which would require landlords to provide a valid reason—such as lease violations or plans to sell the property—before forcing a tenant out. In 2024, the Maryland House passed a version allowing local governments to adopt their own protections, but the bill stalled in the Senate. A promised workgroup never materialized, and renters like Sandra remain vulnerable.

Maryland policymakers are aware of the crisis. Since 2020, the General Assembly has passed over 20 renter protection bills, from banning income discrimination to requiring legal representation in eviction cases. But these measures have been incremental. No legislation has fundamentally changed the eviction process to prevent unjust displacements. Meanwhile, Governor Wes Moore has made housing a priority, citing Maryland’s 96,000-unit housing shortage. But one question looms over this debate: does protecting renters come at the cost of building more housing?

Some argue that strengthening renter protections will discourage investment in Maryland’s housing market, slowing new development. But the reality is that Good Cause Eviction is not a barrier to housing growth—it is a tool that ensures stability for renters while enabling a healthier rental market. A more secure rental environment helps communities thrive, reducing displacement and fostering long-term tenancies that benefit both landlords and tenants. Policies that provide renters with security do not prevent housing construction; they create a more predictable, stable market that encourages responsible development.

Evidence from other cities shows that balancing tenant protections with pro-housing policies leads to stronger, more resilient housing markets. While increasing supply is essential, simply building more units does not guarantee affordability or prevent displacement. In cities that have prioritized rapid development without protections, lower-income renters have been pushed out, eroding the very communities that new housing was meant to serve.

Yet in Maryland, opposition to Good Cause Eviction is built on the premise that any form of renter protection will slow housing growth. This argument is misleading. Landlords and developers have already adapted to new regulations like source-of-income protections and right-to-counsel laws without abandoning the market. Ensuring basic stability for renters is not an extreme policy—it is a necessary step toward solving the housing crisis in a way that works for all stakeholders.

This year, Senate workgroup discussions on Good Cause Eviction have leaned toward a compromise: granting renters lease renewal protections but eliminating hard-fought local rent stabilization ordinances in Montgomery and Prince George’s counties. In other words, tenants could either have lease security or rent stability—but not both.

This false choice is unacceptable. Renters cannot afford to wait years for the trickle-down benefits of a housing surplus while facing immediate threats of eviction. Allowing local governments to determine the level of renter protections that suit their communities is the only fair solution. Maryland lawmakers face a simple decision: will they protect families like Sandra’s, or will they continue prioritizing landlord profits over housing stability?

For thousands of Marylanders on the brink of homelessness, the answer cannot wait another year.

¹Sandra is a pseudonym of a Maryland Legal Aid client who allowed us to share her story.

 

Zafar Shah is the Advocacy Director for the Human Right to Housing at Maryland Legal Aid.

By Jeff Anders

As an organization committed to promoting  access to life-saving therapies for patients with rare diseases, the Rare Access Action Project (RAAP) recognizes the very laudable goal of making medications more affordable. However, with the recent hearings and votes on HB424/SB357, the  Maryland  state legislature is once more debating an expansion of the Maryland Prescription Drug Affordability Board’s (PDAB) authority that among other things would allow it to implement statewide a price control called an upper payment limit (UPL). While the proponents argue that this will address rising healthcare costs, the reality is that UPLs are more likely to have very negative unintended consequences, such as treatment delays and interruptions. Indeed, PDABs will not result in lower drug costs and greater access to treatments, but instead are a disaster waiting to happen with regard to patient access to therapies and care.

Supporters of this experiment argue that PDABs will make medications more affordable. However, these boards fail to account for the complexities of patient access to therapies, especially for treatments targeting rare and orphan diseases, where the stakes are often life or death. While supporters desperately push the talking point of lowering drug costs, PDABs in reality will bring higher patient costs and diminished access to treatments.

Only 5% of rare diseases have a treatment approved by the Food and Drug Administration (FDA) and for one-third of individuals with a rare disease, it can take between one and five years to receive a proper diagnosis. Half of all patients diagnosed with a rare disease are children, and as many as 3 in 10 children with a rare disease will not live to see their 5th birthday. Rare patients face enormous hurdles already in gaining access to these rare disease therapies across our health care system in addition to often being faced with a patient journey filled with misdiagnosis and lack of treatment options. And for some rare patients, the cost assigned to their therapies includes not just the drug, but also services related directly to their care.

Since Maryland passed the first PDAB in 2019, nationwide,  no PDAB has saved any patients or states money. That is the reality. Further, prescription medications account for only a fraction of overall healthcare spending, and the list prices set by manufacturers often differ significantly from the net prices after rebates to and negotiations with plans. In a recently published study, nearly 50 percent of drug costs goes to other actors in health care, including Pharmacy Benefit Managers (PBMs) and insurance plans.

Patients in Maryland largely access their medicines through health benefits; with copays and out of pocket costs assigned by the plans. If patients cannot afford the copays and out of pocket costs, there are non-profit foundations and supplemental assistance to help them. PDABs in other states have disproportionately focused on drugs for rare patients, for which there is often only one medication and limited use. If the PDAB pushes the drug out of reach due to upper payment limits for health care providers, pharmacies, and patients, there is no other choice. This experiment leaves rare disease patients as collateral damage.

Maryland’s proposed PDAB expansion will set a dangerous precedent, positioning the government as an arbiter of medical value and access. For rare patients, this is particularly acute as many patients seek professional care across state lines, and their medicines are sourced outside the jurisdiction of the PDAB. This leaves patients and providers to pay for costs above the UPL to be set by a PDAB. States struggling to implement PDABs have already seen troubling signs of reduced access to innovative treatments, a risk Maryland’s rare disease community cannot afford to take.

PDAB expansion legislation in 2025 represents a challenge for many other patients beyond rare patients. This renewed attempt at government price controls ignores the evidence of harm such measures cause. Lawmakers must reject this terribly flawed experiment and instead prioritize reforms that will genuinely lower patient out of pocket costs without compromising access to critical treatments. For patients with rare and chronic conditions, they need assurances that critical therapies will remain available and that future innovations will continue to address unmet medical needs. They need choices for affordable insurance coverage and the opportunity to ensure that copay and charitable assistance counts toward their out of pocket costs.

The Rare Access Action Project urges lawmakers to resist the allure of experimental solutions like PDABs and instead work toward meaningful, proven reforms that address the drivers of healthcare that impact patients’ out of pocket costs. We strongly encourage our Maryland policymakers to focus on such issues that truly and directly impact patients such as PBM regulation and reform; and copay assistance for out-of-pocket costs.   We stand ready to work with them to find ways to lower patient costs, and improve access to health care in Maryland..

Jeff Anders is a Maryland resident and policy advisor to the Rare Access Action Project.

 

We are in uncharted economic waters. From massive layoffs and spending cuts in Washington to looming tax increases in Annapolis, Maryland entrepreneurs face a range of risks to their businesses. The decisions we make in Annapolis are that much more important, including and especially on policy issues that impact our competitiveness.

There is a balance that needs to be struck across policy and innovation, as always. During its current legislative session, the Maryland General Assembly has an opportunity to do just that. One year ago, the legislature passed the Maryland Online Data Privacy Act, a well-intentioned law that unfortunately has had many unintended consequences for businesses and nonprofits of all sizes across our state. Thankfully, Delegate Andrea Harrison has put forward a critically important bill this session – HB 1365 – that would provide simple, clear adjustments to the bill that maintain its ability to protect consumer data while easing the burden on small businesses.

Maryland can be an economic leader by encouraging innovative products and services and creating pathways to entrepreneurial success – not imposing stricter data privacy standards than even California or Europe.

From scrappy entrepreneurs working through the night to deliver innovative solutions for Marylanders and the world, to iconic research institutions and companies advancing groundbreaking new technologies – we owe it to Maryland startups to keep their regulatory path as clear as possible.

Without a comprehensive federal privacy law on the books, states have taken the lead over the past few years. We appreciate the intention, and wholly support the goals that Maryland policymakers have set out to achieve. But for today’s business owners, especially small shops and startups, it’s critical that we avoid setting dramatically different or even competing standards than our neighbors. Beyond preserving the ability for small businesses to leverage digital marketing and other online tools, Delegate Harrison’s legislation, HB1365, aligns Maryland’s privacy law with other states along the East Coast that have passed their own laws – including Connecticut, Rhode Island, and New Hampshire. Regional compatibility matters for small businesses.

At the core of the issue is keeping Maryland’s data privacy framework workable for small businesses, nonprofits, life sciences and tech innovators, and entrepreneurs who have increasingly turned to digital marketing and custom online experiences in recent years to reach new and existing consumers. HB1365 provides the clarifications necessary to preserve those critical functions.

The Maryland General Assembly can move this crucial legislation forward confident they are empowering our small businesses at a time they sorely need it. Passing HB1365 will represent a step in the right direction during turbulent times. We have the opportunity to preserve robust data privacy protections for Maryland’s consumers, while at the same time supporting small businesses and keeping the door open for innovation. Let’s take it.

 

Kelly Schulz is CEO of the Maryland Tech Council, the largest technology and trade association in the state. She previously served as Maryland Secretary of Commerce and Maryland Secretary of Labor.

By Dominique Daniels

Two weeks ago, I testified before both the House Government Operations Committee and the Senate Finance Committee about legislation to expand the authority of the Prescription Drug Affordability Board (PDAB).

I tried to explain to my legislators that this PDAB expansion was the wrong path for patients across Maryland, who just like me, are watching these boards crop up across the country and we are scared.  We are scared that pharmacies won’t be able to afford to stock our medicine, we are scared that our insurance company and its Pharmacy Benefit Manager will decide to change the formulary and not cover my medicine, and we are scared that the PDAB’s indiscriminate decisions to put any drug on the list that our medicine will be next.

Unfortunately, all I heard was more lip service to patients.

I heard from the Chairwoman, “we’re doing this for you.”

Are they?

I know that actions speak louder than words, and up to this point there’s been a distinct lack of action for patients from the Prescription Drug Affordability Board (PDAB), its staff, or our elected officials.

Take a look at the latest “Proposed Regulations – Review of Comments” from the Prescription Drug Affordability Board. Nearly every recommendation that was brought forth by patients, the organizations that advocate for us, and others was recommended for “No Action” by the PDAB staff. I have spoken with numerous other patients and their organizations and not one person has had outreach from the PDAB or the staff.

So, I ask again. Is this really for patients like me? Because it sure doesn’t seem like those in power are really listening.

Patients don’t want the PDAB, let alone expand its authority.

It’s alarming that neither the PDAB nor the legislators creating these policies can articulate how they will assure patients aren’t impacted by an upper payment limit.

What happens when my doctor tells me that because of the upper payment limit on my medication, my insurance company isn’t going to cover my carefully dialed in medication, and now I have to use an ineffective medicine? Or what if my pharmacists can’t afford to carry my medicine anymore because of the low reimbursement?

How is the PDAB going to protect me?  The Board continues to say that there will be no access issues but has failed to explain why.

Limiting access to life-saving medication should not be an option, yet that’s exactly what an upper payment limit will do to my medication.

Do you have any idea how scary that is? After years of dialing in the medicines that my body needs to function, it’s being experimented on by people who don’t know me or my doctor. I have to put my life in the hands of an unelected board of “health economists,” as Delegate Cullison told us.

Clearly, the Maryland General Assembly cares far more about scoring political points than the health of their constituents.

As a Marylander, I am disheartened to see my elected representatives wholly disregard me and the warnings of so many other patients about the impact an expansion of the PDAB’s authority will have on their constituents’ health.

Why not wait to see what happens with other states? Why don’t we take care of patients who have rare diseases? Why don’t we include patients on the board?

I get it. Lowering prescription drug costs is a big winner in polls. I actually agree. We should be trying to lower patients’ out-of-pocket costs, but how you do that matters, and the sole tool that the PDAB is utilizing is not the answer. It’s hard to understand why they are rushing to expand the PDAB authority with so much opposition from across the spectrum when there are so many other proven options to save out-of-pocket costs for patients.

I ask our elected officials, is a political win so important that you are willing to risk my life, and the health of thousands of others, to score a political point?

Dominique Daniels is a Crohn’s patient from Baltimore City and manager of Community and Patient Support for Color of Gastrointestinal Illnesses.

In the grand sweep of American history, we have often been tempted to defer the difficult decisions of governance in favor of expediency or political convenience. Yet, there are moments when reality compels us to confront the unavoidable truths of our collective predicament. Such a moment is now upon us, and it concerns the solvency of our national budget. To speak plainly, the federal budget cannot be rendered solvent without the reformation of entitlement programs—Social Security, Medicare, and Medicaid. Without such reform, we are hurtling toward what can only be described as a fiscal death spiral, an inexorable trajectory toward insolvency.

Consider, if you will, the data furnished by the nonpartisan Congressional Budget Office (CBO). It projects that the national debt held by the public will surpass 106 percent of Gross Domestic Product (GDP) by 2027. To place this in perspective, the historical average over the past half-century has been a far more modest 48 percent of GDP. This vertiginous ascent is fueled by perennial federal budget deficits, forecasted this year to exceed $1.9 trillion. Such deficits are the arithmetic byproduct of expenditures chronically outstripping revenues, a phenomenon exacerbated by the ravenous appetites of entitlement programs.

Social Security, Medicare, and Medicaid—the so-called “sacred cows” of American politics—consume an ever-expanding share of our national resources. Left unchecked, they threaten to engulf the entire federal budget, crowding out other vital priorities and rendering the government incapable of responding to unforeseen crises. Indeed, the very premise of their sustainability has been rendered dubious by demographic realities: an aging population, declining birth rates, and a shrinking ratio of workers to beneficiaries.

Compounding this fiscal challenge is the reality that the United States has funded wars in Afghanistan and Iraq, the bailouts during the Great Recession, and the programs to alleviate the effects of the COVID pandemic by borrowing money and not paying for them. The invoice for these endeavors is now due, and we cannot continue this pattern of fiscal irresponsibility without grave consequences.

Let us dispense with the fallacy that the national debt is a mere abstraction, a bogeyman conjured by fiscal scolds. The consequences of our mounting indebtedness are as tangible as they are dire. High and rising debt suppresses economic growth by diverting capital from productive investment to service interest payments. It erodes our standard of living, renders us less competitive on the global stage, and constrains our capacity for fiscal maneuvering in times of national emergency. Worst of all, it imposes a staggering burden on future generations, who will inherit the debts of our profligacy without enjoying the benefits of our largesse.

As Maya MacGuineas, president of the Committee for a Responsible Federal Budget, aptly observes, “Borrowing is not free; it comes with costs that will fall hardest on the next generation. Without changes, we risk leaving our children a legacy of debt, slower growth, and reduced opportunities.” Her warning underscores the urgency of addressing our fiscal challenges before they spiral further out of control.

Yet, these outcomes are not inevitable. As the CBO notes, policymakers retain the capacity to chart a more sustainable fiscal course. This requires both a reduction in the rate of spending growth and an enhancement of revenue streams. Among the options are measures to curb overpayments in Medicare Advantage, equalize Medicare payments for similar treatments, and raise the retirement ages for Social Security and Medicare eligibility. These are not draconian measures; they are prudent adjustments to programs whose underlying structures are misaligned with contemporary demographic and economic realities.

Moreover, we must not shy away from politically unpalatable but necessary revenue measures, such imposing a FICA payroll surtax on high incomes, and enhancing the efficiency of tax collection through better funding of the Internal Revenue Service. Such measures can be calibrated to preserve economic competitiveness while contributing meaningfully to deficit reduction.

The opponents of entitlement reform argue that such programs are the bedrock of social stability and economic security. This is true. But to preserve these programs for future generations, they must be reformed to reflect the fiscal and demographic realities of our time. Failure to act is not a neutral option; it is a decision to allow these programs to collapse under their own weight, taking the federal budget—and perhaps the American economy—down with them.

In closing, let us invoke a principle articulated by the late Edmund Burke, who observed that society is a partnership between those who are living, those who are dead, and those who are yet to be born. If we are to honor this intergenerational compact, we must act decisively to place our fiscal house in order. Reforming entitlement programs is not merely a matter of arithmetic; it is a moral imperative. Let us rise to the occasion.

The author is an attorney who resides on the Eastern Shore and is co-host of the Gonzales/Mitchell Show podcast.

Independent pharmacies across Maryland are singularly focused on one urgent priority: pharmacy benefit manager (PBM) reform. As Congress considers the future of healthcare policy, the opportunity to take meaningful action on PBMs is here—and it must not be missed. For too long, these corporate middlemen have driven up drug costs, squeezed local pharmacies to the point where many have gone out of business, and limited patient access to affordable medications. As an independent pharmacy owner in Maryland and the CEO of EPIC Rx, I have seen first-hand the detrimental effect on our communities.

Maryland’s congressional delegation, and every member of Congress, has a critical chance to act now, building on the body’s prior success in lowering prescription drug costs. We need PBM reform, and we need it now.

PBMs wield enormous power in our healthcare system. Originally intended to manage drug plans and negotiate discounts on behalf of patients, these entities have evolved into profit-driven intermediaries forcing higher costs on patients. Today, three PBMs control nearly 80% of the market, giving them significant leverage over drug pricing, pharmacy reimbursements, and patient access to medications. This consolidation allows PBMs to determine which drugs are covered, how much patients pay out of pocket, and even which pharmacies survive.

Independent pharmacies, in Maryland and across the country, have felt the brunt of PBM practices. These small businesses—many of them family-owned and deeply rooted in their communities—are struggling to stay afloat due to below-cost reimbursements and retroactive fees imposed by PBMs. Every time a local pharmacy closes, patients lose a vital point of care, especially in rural and underserved areas where these pharmacies often serve as the primary healthcare providers.

Our communities have already seen the negative impact of unchecked PBMs, with increasing closures of community pharmacies and patients forced to travel farther to get their medications. In some cases, PBM-owned mail-order services are the only option, leaving patients with fewer choices and less personalized care. This trend is unsustainable—and it’s harming the people who can least afford it.

The push for PBM reform is not just about supporting small, independent pharmacies like mine and the communities we service—it’s about putting patients first. Reform will inject transparency into a system that has operated in the shadows for too long. It will ensure that the savings negotiated between PBMs and drug manufacturers are passed along to patients rather than being pocketed by intermediaries. PBM reform will protect small pharmacies from predatory practices, giving them a fair chance to serve their communities and compete on a level playing field.

We have worked diligently with the Maryland General Assembly to help pass some small relief, but we can’t compete with companies listed near the top of the Fortune 25 biggest companies. Every time we close one loophole, they just find another way to gouge patients and their pharmacists.

Now, Maryland’s congressional delegation can and must play a leading role in this effort. Congress has already laid the groundwork with historic efforts to lower prescription drug prices, such as the Inflation Reduction Act’s Medicare reforms. But PBM reform is the crucial next step in this journey. Without it, patients will continue to pay more for medications, and local pharmacies will continue to close their doors.

The opportunity to pass PBM reform is here, and the time to act is now. Maryland’s members of Congress have a chance to build on the progress already made by embracing this reform, ensuring that the savings and benefits of drug price reductions reach patients—not just corporate middlemen. Delay is not an option.

Independent pharmacies are ready to do their part, but they need the support of Congress to succeed. Maryland’s lawmakers have a responsibility to act decisively—reform PBMs, reduce the cost of prescriptions, and preserve access to care for patients everywhere. They have their chance over the next couple of days to start helping independent pharmacies by voting “yes” on the spending package before them. Let’s put patients first, protect our local pharmacies, and make sure that the healthcare system works for everyone. The time for PBM reform is now.

Brian Hose is an independent pharmacy owner in Sharpsburg, Maryland and the CEO of EPIC Rx, a national leader of pharmacy services support for independent pharmacies.