Advocates fight to restore funding cut from children's health program

Legislators voted to trim $2.4 million from budget

November 01, 2003|By Lynn Anderson | Lynn Anderson,SUN STAFF

Children's advocates are stepping up their efforts to reverse $2.4 million in state budget cuts to a pediatric health care program, arguing that more Maryland children will fall into the ranks of the uninsured.

Because of the cuts, enrollment in the Maryland Children's Health Program may be down for the first time since its inception in 1998, according to the Maryland Budget and Tax Policy Institute, a research group in Silver Spring, which warns that visits to hospital emergency rooms by uninsured children could push up health costs for other residents.

"The Maryland Children's Health Program, which has been one of the nation's leaders in providing coverage to uninsured children, has stalled," said Patrick Lester, senior policy analyst and author of a report released to The Sun this week. "Higher levels of uncompensated care will drive up private health care costs by millions of dollars per year."

The program provides free and low-cost medical, dental and vision care for about 113,000 children statewide, and the timing of the budget cuts couldn't be worse, Lester said.

The most recent Census data shows that the number of Maryland residents without health coverage is growing for the first time in years, up from 11.3 percent in 2001 to 12.0 in 2002. Children are among the newly uninsured, Lester said, a situation that could lead to irregular medical treatment and life-long developmental problems.

State Health Secretary Nelson J. Sabatini is standing by lawmakers' decision to cut the health care program despite a timely infusion of federal funds. Congress voted recently to extend the availability of $2.7 billion nationally for child health care programs. Of that, Maryland is entitled to between $158.1 million and $167.7 million, according to federal and state sources.

"This is not a windfall," said Sabatini, who heads up the Department of Health and Mental Hygiene. "The federal funds will be eaten up just to fund the current program."

Some lawmakers and child advocates disagree.

Sen. James Brochin, a Democrat from Baltimore County and member of a joint legislative committee that recommended against the cuts in July, said he still believes it would be best to reverse the budget action, especially given the influx of federal funds.

"When you have $167.7 million and you are not willing to put $2.4 million in for kids who are uninsured at no fault of their own, there seems to me to be a real basic misunderstanding," Brochin said.

Sabatini said he is playing it safe. He said that federal Medicaid funds are expected to dry up, and the children's health care program could suffer a debilitating budget shortfall as a result.

"That money is essential to fund the current program, as is, with no growth," Sabatini said. Enrollment in the program already has been capped for families in higher-income brackets as a result of state budget constraints. Families that used to receive free medical care now pay a $37-a-month premium.

For years, Maryland's program has been a model. Since 1998, state officials have reached out to thousands of uninsured families, many of them headed by working adults whose annual incomes might otherwise have disqualified them from Medicaid.

Because of the success of its program, Maryland has received millions of dollars in "reallocated" federal funds that were not used by other states for similar health programs. But more recently, states that were slow to organize their programs are catching up and spending all of their allocated dollars.

Sabatini said he believes that the Maryland Children's Health Program could be operating under a $20 million to $30 million budget shortfall by 2006. The cost of providing Medicaid programs is also rising, he said.

"We anticipated a shortfall sooner than 2006, but this reallocation of federal funds has allowed us to push that out a bit," said Sabatini, who did not recommend cuts to the program to Gov. Robert L. Ehrlich Jr. As a result, the governor did not include cuts to the children's health care program in his budget. The cuts were approved by the legislature.

Children's advocates say they aren't giving up.

Jan Schmidt, government relations director for Advocates for Children and Youth, has sent letters and met with key legislators including House Speaker Michael E. Busch in hopes of forestalling further cuts in the next budget cycle.

"To me this is just horrifying," said Schmidt.

Some legislators who voted to make the cuts have since changed their mind.

"I question whether the [health] secretary understands that these people will get health care anyway," said Brochin, adding that the uninsured will still make visits to hospital emergency rooms. "But it will cost the taxpayers more."

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