Children of the Working Poor

August 15, 1993

Maryland's latest Medicaid waiver helps to address one of the more glaring gaps in this country's health care system -- basic care for the working poor. With the new waiver, the state will offer preventive visits to the pediatrician, immunizations, prescription drugs, vision care and some other services to the children of the working poor, those families that earn too much to qualify for Medicaid coverage, but not enough to afford their own health coverage.

The plan will not cover hospitalization, which will make it significantly less expensive for the taxpayers than traditional Medicaid policies. For $3 million, shared by the state and federal governments, Maryland hopes to cover as many as 15,000 children between the ages of 1 and 9 1/2 .

That's a bargain, an investment that will repay itself many times over. The best way to keep anyone healthy and to avoid high medical costs is to catch problems early, when treatment is simpler and more likely to be effective. That is especially true for children, for whom regular check-ups, timely immunizations and quick attention when an infection or other problem crops up can usually make hospitalization unnecessary.

Under the current system, many working families are stuck in a cruel bind. They make too much to qualify for Medicaid assistance, but family health care policies are priced beyond their reach.

So, all too often, other pressing needs come before a visit to the pediatrician or the antibiotic a child needs to nip an ear infection in the bud. As a result, many of these children end up in emergency rooms, costing hospitals far more than a timely visit to a doctor. The bill for this care often ends up being shared by all insured patients, thus adding to the rising health insurance tab.

Maryland's program is economically sensible, but above all it is humane. It simply makes no sense not to provide young children with the basic, inexpensive care that keeps them healthy and helps them grow strong. No family, especially those who struggle heroically to stay off public assistance, should have to choose between a medicine for a sick child and paying the rent to avoid eviction, or between food on the table and a medical check-up.

Any effort to expand basic, preventive health coverage deserves encouragement, and no group is more deserving than the children of families who are proving every day that with a little bit of help they can be lead productive, self-sustaining lives.

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