Caring for children Health insurance: Why the House bill is better than Gov. Glendening's plan to extend Medicaid.

March 22, 1998

THE HOUSE VERSION of a bill to give children from low- and moderate-income families health insurance costs about the same as Gov. Parris N. Glendening's sweeping plan to extend Medicaid.

But philosophically, it is quite different in important and advantageous ways.

The governor's plan, which has passed the Senate, would create a new entitlement -- free health care for children and pregnant women in families making up to 200 percent of poverty, or about $32,000 for a family of four.

The entitlement would extend to those with access to private insurance, which they could drop and then sign up for the free plan after 90 days.

The impetus behind this is the offer of hundreds of millions in federal aid over the next five years to states that set up children's insurance programs. Yet this isn't "free" money -- it is tax dollars -- and it is only guaranteed for five years.

Mr. Glendening's proposal holds that it is government's job to take care of the medical needs of low- and moderate-income children. Supporters want families to abandon private insurance for Medicaid because they say its plan for children is better than some private health insurers'.

The House version would help as many families as the governor's plan and would likely commit Marylanders to a sizable, long-term expense. But it stresses responsibility. Families making 185 percent to 200 percent of poverty ($29,600 to $32,000) would have to pay a small premium.

It discourages dependence on government and would not drive up private insurance costs by drawing healthy children out of the insurance pool. Those wishing to eschew private coverage for free government health care would have to wait six months after dropping the private plan. There would be little incentive to do that, because the state would provide vouchers to cover the cost of private insurance for dependents in families making up to 200 percent of poverty.

No one wants children to go without health care; taxpayers pay the bill when that happens, too. But there is no consensus that government should simply hand out health benefits. The House bill recognizes that.

Pub Date: 3/22/98

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