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Legislation would aid needy children

March 21, 1998|By GUY FLETCHER

Legislation would aid needy children

ANNAPOLIS - Health care legislation in the Maryland General Assembly would provide immunizations, physical exams and other medical services to more than a thousand children of working poor families in Washington County, officials said.

"It's a major infusion of new money into health care for women and children, particularly children," said Bill Wood, executive director of the Tri-State Community Health Center in Hancock.

The legislation came from Gov. Parris N. Glendening proposal to expand the state's Medicaid program for children and pregnant women with $29 million from the state and $47 million from the federal government.

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The new program would provide health insurance to 60,000 poor children across the state. The program could help about a third of the 4,268 uninsured children in Washington County, according to state estimates.

"There is definitely a need for this program," said Dr. Robert L. Parker, Washington County health officer.

The program would allow the state to pay for health care for children up to 19 years and pregnant women to twice the poverty level. For a family of four, the income limit would be $32,900.

Supporters said the program will help people who are not affluent enough to afford private insurance but who also exceed current Medicaid income limits, which get lower as a child gets older. The result has been a "patchwork quilt" of services and qualifications that can be confusing, Wood said.

"It makes it very difficult for people to receive consistent care for all members of the family," he said.

Wood said health centers like his would also benefit from the program by seeing a reduction in caseload. The Tri-State center, with a staff of three physicians, two physician assistants and several nurses, sees about 6,000 patients a year, he said. As many as half of the center's patients are uninsured, and hundreds of those are children, he said.

"There's nothing bad about this," Wood said.

Still, passage of the legislation is no guarantee. Some lawmakers have complained about the state's cost, which could increase if the federal government decides not to increase its funding beyond a five-year commitment.

To address those concerns, the House of Delegates amended its version of the bill to include co-payments from those patients near the top of the income limits. A family of four earning $32,900 would pay $987 a year, while a family of two earning $20,073 would pay $201.

"This is not big government expanding, but rather something the working poor will be able to afford," said Del. John P. Donoghue, D-Washington, who heads the House subcommittee on health care.

Last week the legislation was criticized by many lawmakers as being a vehicle for expanding abortions in the state. Official estimates have 60 more abortions being performed each year because of the program.

Abortion opponents tried unsuccessfully to tighten the language so the program only pays for abortions in cases of rape, incest and to protect the life of the mother.

Last Friday the House voted 133-2 to approve the bill, but it must reconcile significant differences between its and the Senate's version of the legislation, which was approved early this year.

The Senate version is a true expansion of Medicaid and has no co-payments, while the House version leans more on private insurers and seeks donations to offset the state's cost.

"It has been our position since the beginning that a straight Medicaid expansion would be both inadequate and in certain instances inappropriate to connecting health care to the children," said House Speaker Casper R. Taylor Jr., D-Allegany.

A conference committee from both houses will now try to reach a compromise on the differences.

If the legislation is approved, the state would then face the task of trying to market the program to the uninsured families. Parker, the county health officer, said that could prove difficult because many of the qualifying families have never dealt with public assistance programs before and might be reluctant to enroll out of pride.

"There's going to be a real need to sell the program and outreach to those families," Parker said.

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