Proposal would insure children Glendening suggests extending Medicaid to 60,000 youngsters

U.S. would provide two-thirds of funding

December 16, 1997|By William F. Zorzi Jr. | William F. Zorzi Jr.,SUN STAFF

Gov. Parris N. Glendening proposed an ambitious expansion of Medicaid coverage in Maryland yesterday to include full health care for nearly 60,000 poor children and pregnant women.

The new program, about two-thirds of which would be funded with federal dollars, would cover children through age 18 and pregnant women who are not covered by health insurance or who have limited benefits. Over the next three years, the state's share of the cost would grow from $29.4 million next year to $36.8 million in the year beginning July 1, 2000.

The program -- dubbed "Maryland Children's Health Program" by Glendening -- would be open to children and pregnant women whose family incomes fall below 200 percent of the federal poverty level. For a family of four, that amount is $32,112 a year.

"In a state as wealthy as ours, it's absolutely intolerable that there are children who are sick and suffering and don't have medical coverage," Glendening said.

Glendening made the announcement -- the first piece of his 1998 legislative agenda -- at the Annapolis Family Support Center, accompanied by Rep. Benjamin L. Cardin, a Baltimore Democrat who championed the issue on Capitol Hill, a couple of legislators, child advocates, and several poor mothers and their children.

Dr. Timothy F. Doran, a Towson pediatrician and president of the Maryland chapter of the American Academy of Pediatrics, said he was "delighted" with Glendening's effort to offer health care to those families who fall in "the gray zone" -- those who earn too little to afford health insurance but too much to be eligible for Medicaid.

Under Glendening's proposal, eligible mothers-to-be and children would be included in HealthChoice, Maryland's Medicaid system, in which services are provided by nine private managed-care organizations. About 255,000 children statewide are eligible for Medicaid benefits, which include hospitalization, vision and dental care, prescriptions, and mental health and substance abuse treatment.

Needs approval

The governor's plan must be approved by the Maryland General Assembly, where some provisions will likely be opposed during the session that begins next month.

In its past session, the legislature rejected a significantly less ambitious, but entirely state-funded, program proposed by Glendening, "Thriving by Three." That program would have offered health coverage to pregnant women and children to age 3 at a cost of $5.6 million a year.

Arguments against that plan centered on a desire by some legislators to have recipients pay toward the coverage, either through a co-payment for each treatment, which has since been ruled out by the federal government, or a premium.

The latest proposal will be aided by the availability of federal money that Congress set aside in August in passing the Balanced Budget Act of 1997. States can share $24 billion over five years to pay for expanded Medicaid programs.

Seven states have sought federal approval for plans similar to the governor's proposal or for private medical insurance.

Glendening's announcement came within hours of the State Board of Revenue Estimates' projection of a $260 million surplus this year -- news that could make the proposal more palatable.

Skepticism

Nevertheless, some legislators yesterday expressed skepticism about the chances for the plan as outlined.

"If Thriving by Three couldn't get passed, and it wasn't, I don't know how they're going to get this passed," said Sen. Barbara A. Hoffman, the Baltimore Democrat who chairs the powerful Budget and Taxation Committee.

Hoffman, who supports the program in concept, said she did not want to expand Medicaid to take in working families -- those approaching or at the upper limit of 200 percent of poverty level.

"There are ways for us to help these people to enter the insurance market," she said. "Certainly we can design a system that allows us to pay an insurance premium, for instance, instead of us paying all of the health-care cost.

"Anything we do to hook them into the regular world of work is beneficial -- and not stigmatizing," Hoffman said.

Those objections are similar to those raised in the House, where the governor's Thriving by Three program died last session.

'No-brainer'

But some legislators, such as Del. James W. Hubbard, a Prince George's County Democrat, called support for the governor's program "a no-brainer."

Hubbard, who sits on the Environmental Matters Committee, which handled Glendening's proposal in the past session, dismissed the House's earlier objections as "purely political."

In a fiscal blueprint for the coming legislative session released yesterday, House leaders "endorsed the concept" of the children's health program and recommended setting aside $25 million in the fiscal year that begins July 1.

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