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A new poll shows that despite the struggling economy, voters support expanding health coverage to more Marylanders. But as some business leaders are supporting higher taxes to pay for health care expansion, others say the economy and an approaching election could be high hurdles to health care reform in Maryland.

Sixty-three percent of voters said the sputtering economy has made it "more urgent" to address health care reform as opposed to not taking on reform efforts, according to the survey commissioned by the Maryland Citizens' Health Initiative.

The telephone survey of 700 likely voters in 2010, conducted May 11-14 by the progressive national polling firm Lake Research Partners, also found support for a state plan that uses a 2 percent increase in the payroll tax and tax increases of 10 percent on alcohol and 75 cents per pack on cigarettes to fund the expansion of Medicaid coverage.

A plan passed by the General Assembly during the 2007 special legislation session has expanded Medicaid to more than 40,000 Maryland parents — some 15,000 more than the state had expected by this time — but with a downturn in state revenues, efforts to expand health care to childless adults have stalled.

The poll results come a week after the Greater Baltimore Black Chamber of Commerce joined black chambers from Anne Arundel and Prince George's counties in supporting the plan.

"I think the two of them together, the poll results and the support from the black chambers give big momentum to what we are doing," said Maryland Citizens' Health Initiative President Vincent DeMarco, adding that it was the first time that chambers of commerce in Maryland had endorsed a health care plan that requires employers to pay.

"It's going to cost employers a little bit of money, but over the long run they make something on it," said Hubert "Petey" Green, president of the Prince George's County Chamber of Commerce.

But not everyone is on board.

The plan is identical to legislation introduced this year by Sen. Verna L. Jones that stalled in the Senate Finance Committee in the face of opposition by the Maryland Chamber of Commerce and an economy in which lawmakers refused to attach any new taxes to the state budget.

Opposition to the plan is not likely to change.

"I think you'd find very few businesses advocating a 2 percent payroll tax, especially in this recession," said Ronald W. Wineholt, a lobbyist for the state chamber.

Lawmakers are not likely to bite either, Senate Finance Committee Chairman Thomas McLain Middleton said.

"I think you're going to have a lot of apprehension during an election year to having a payroll tax," said Middleton (D-Dist. 28) of Waldorf.

With President Obama (D) urging Congress to pass national health care reform by October, legislators expect the issue to take on renewed urgency at the state level.

"There's going to be a push next year to do something because things are happening at the federal level," said Middleton, who met last week with House Health and Government Operations Committee Chairman Peter A. Hammen (D-Dist. 46) of Baltimore and state health Secretary John M. Colmers to begin discussions of what federal developments could mean for state legislation.

Advocates vow that in 2010 they will be "ready with our plan to fill in any gaps that the feds leave," DeMarco said.

The black chambers' position "shows that the Maryland chamber does not speak for everyone," said Jones (D-Dist. 44) of Baltimore. Jones called the chamber "very conservative," adding that its members "have to realize how business will contribute to the solution of health care for all."

Green said he hopes to chip away at the state chamber's opposition.

"We're going to keep pushing, and I know they're pushing back," he said. "I'm not a fan of the tax, but it's the only way to get it done."