Senate puts high priority on health bill $29.4 million measure to insure children hits floor on 2nd day

House has other ideas

Differences on how to structure program might slow its passage

January 16, 1998|By Michael Dresser | Michael Dresser,SUN STAFF Sun staff writer C. Fraser Smith contributed to this article.

The Maryland Senate has put Gov. Parris N. Glendening's sweeping children's health care initiative on an unusually fast track, but the program could hit speed bumps on the way to his desk.

The administration's bill creating the program -- which would cost $76.2 million in state and federal funds -- reached the Senate floor on the second day of the 90-day legislative session.

Floor amendments and preliminary approval were put off until Tuesday, but the unusually early movement of the bill is a sign of the high priority the Senate leadership is putting on the legislation -- one of the top items on Glendening's election year agenda.

Sen. Thomas L. Bromwell, chairman of the Senate Finance Committee, predicted the bill would pass the Senate as early as Thursday.

"Everybody wants to provide health care to the working poor," the Baltimore County Democrat said. "Every legislative district will be able to take advantage of this program."

House leaders say they share the Senate's desire to pass a bill, but they have different ideas about how to structure such a program. The differences will have to be reconciled if the bill is to become law.

The Maryland Children's Health Program would provide health insurance to children younger than age 19 and pregnant women in households with incomes up to 200 percent of the federal poverty level -- or about $32,000 for a family of four.

It takes advantage of a new federal law providing almost $2 for each dollar of state spending to provide such coverage. Glendening has proposed $29.4 million in state spending in fiscal year 1999, to be matched by $46.8 million from the federal government.

The committee got an early start on the session by approving the bill unanimously last month. Bromwell said his panel acted quickly to promote efficiency in the Senate and to "send the House a message."

He recalled that a less ambitious version of the bill covering children up to age 3 -- dubbed Thriving By Three by Glendening -- passed the Senate unanimously last year, only to die when the two chambers could not agree on a final version.

This year, despite a much higher price tag, the chances for agreement appear better. The House, too, is moving quickly to deal with the bill -- though not with the speed of the Senate. Del. Michael E. Busch, an Annapolis Democrat and chairman of one of the two House committees dealing with the legislation, said a hearing on the bill is set for Wednesday.

Both chambers hope to have a bill passed relatively early in the session so they can begin negotiating a compromise.

The Senate bill's approach is to adopt the governor's proposal to provide the coverage through a straight forward expansion of the state's Medicaid managed care program.

Administration officials say that is the best way to get the program running quickly without having to set up a new administrative structure.

But House leaders say they are not sure a simple Medicaid expansion is the right way to set up the program. Both Busch, who heads the Economic Matters Committee, and Del. Ronald A. Guns, the Cecil County Democrat who chairs the Environmental Matters Committee, have expressed concern about creating a new entitlement similar to welfare.

They have suggested that Maryland might set up a program of its own, requiring people at the higher end of the income range of those covered to contribute a share of the cost. Busch said House members are also concerned about the cost in five years, when the federal contribution will drop to 50 percent.

fTC Busch said the House is not ruling out the Glendening approach but wants to make sure all possible options have been explored. If its ideas prove impractical, he said, "We might embrace the governor's program."

In Annapolis

Highlights in Annapoolis today:

Senate convenes to vote on resolution to expel Sen. Larry Young, 9 a.m., Senate chamber.

House of Delegates meets. 10 a.m., State House.

House Appropriations and Senate Budget and Taxation committees briefed on poverty issues by advocates for the poor. 1 p.m. Room 130, House office building.

House Environmental Matters Committee briefed on Medicaid managed care and other health issues. 1 p.m. Room 160, House office building.

Pub Date: 1/16/98

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