Schaefer proposes care for children who are uninsured

February 12, 1993|By Michael Hill | Michael Hill,Staff Writer

The Schaefer administration wants to pay for doctor visits, diagnostic tests and other routine medical care for 15,000 uninsured children who currently do not qualify for Medicaid.

The proposal comes at a time when most states, including Maryland, are cutting back on their expensive medical assistance programs by tightening eligibility requirements.

But state officials say that paying for care that might keep children healthy would be money well spent.

The state's proposal will be one of the first tests of the Clinton administration's promise to make it easier for states to get waivers from federal Medicaid rules so they can try new health care ideas.

Under current regulations, a state can choose to offer Medicaid coverage to so-called "gray area" children only if it will pay for a full range of medical care, including hospitalization. Such coverage costs about $1,500 per child each year.

Maryland is asking for a waiver from the federal rules so that it could provide more limited coverage, at a cost of about $200 per child. The total cost of $3 million would be split between the state and federal governments.

The additional coverage would go to children who, depending on their family income, currently are covered by Medicaid until the age of 1 or the age of 6. The new coverage would be provided until they are 9 1/2 .

These are the children of families with incomes of up to 185 percent of the federal poverty level, or roughly $26,000 a year for a family of four.

"When President Clinton spoke to the governors, he told us, 'Don't be afraid to do something new, try something new,' " Gov. William Donald Schaefer said yesterday.

Under the proposal, Medicaid would pay for doctor visits, tests, immunizations, vision care and co-pay prescription services. It would not cover hospitalization. If the children required hospital care, they would continue to depend on an existing system in which hospitals share the burden of charity cases.

"The idea is to change the cycle of spending tremendous amounts of money on very expensive care by spending less money up front to keep people from getting sick," said state Health Secretary Nelson J. Sabatini.

He said that a number of state agencies are currently at work on the proposal, with the Department of Human Resources working on the eligibility rules and the health department on operational matters.

State officials said that in the past it has taken anywhere from six to 18 months to get a waiver like this. But with the Clinton administration promising the process would be made easier, they are expecting quick action on this request.

"I don't see any reason we're not going to get the waiver quite soon," Mr. Sabatini said.

"On a budget basis, we're assuming that it will start in the next fiscal year," which begins July 1, Mr. Sabatini said. "But we will be ready to go sooner than that, and the governor has told me that we should go ahead, that he will find the money someplace."

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