Bills take 2 approaches to child health coverage House, Senate envision different programs

March 13, 1998|By Michael Dresser | Michael Dresser,SUN STAFF

Two House committees voted yesterday to approve a similar but competing alternative to Gov. Parris N. Glendening's $76.2 million children's health insurance initiative that has the Senate's backing.

The combined 44-1 vote by the Economic Matters and Environmental Matters committees sends the bill, backed by Speaker Casper R. Taylor Jr., to the House floor, where it is expected to be approved overwhelmingly next week.

The committee's action ensures that the House and Senate will go to conference with different philosophical approaches on how to expand health care coverage for children from low- to moderate-income families.

But in practical terms, the House program and the governor's proposal differ little for more than three-quarters of the children who would be covered.

"They're much more similar. The differences aren't that substantive," said Taylor, who predicted the two chambers would reconcile the bills without much difficulty.

The governor's ambitious children's health initiative has been made possible by a new federal program that will pay almost two-thirds of the cost of insuring children up to age 19 from families with incomes up to 200 percent of the poverty level. Both the House and governor's plans would cover pregnant women from such families as well.

The Senate moved in the early days of this year's session to approve Glendening's proposal to offer coverage by expanding the state's Medicaid managed-care program.

House Democratic leaders, however, announced early in the session that they wanted to avoid a program with Medicaid-like entitlements.

While the governor's program piggybacks on the federal Medicaid entitlement program, the House legislation establishes a separate state-run program.

In many respects, the House bill mirrors Maryland's Medicaid managed-care program, which uses private insurers to provide coverage. But unlike the current program, it would require some participants to pay a premium.

The House legislation would require households with incomes between 185 percent and 200 percent of the federal poverty line -- roughly $27,000 to $33,000 for a family of four -- to pay premiums between 1 percent and 3 percent of household income. Families with incomes between 100 percent and 185 PTC percent of the poverty line would pay no premiums under either bill.

Advocates for the poor have opposed the premium provisions of the bill, arguing that they would deter some families from signing up.

The House bill does not significantly change the cost of the program, which Glendening has budgeted this year at $29.4 million in state funds -- to be matched by $46.8 million in federal money.

The bill was crafted with significant input from Republican members, who pushed successfully for safeguards to ensure that the program would not attract families who are covered by employer-sponsored plans.

Joseph C. Bryce, the governor's chief legislative officer, said Glendening is pleased that the House agrees with his basic goal of covering 60,000 children. "He's become a little concerned with how complicated it's become, but he doesn't think it's anything we can't work through," Bryce said.

Pub Date: 3/13/98

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