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The '99 health debate

December 02, 1998

A Maryland health insurance program for low-income children and pregnant women launched five months ago is already halfway to its goal of covering 60,000 children, prompting advocates to argue that it should be expanded. It's one of the key issues that will face the 1999 session of the Maryland General Assembly.

Until this week, we'd have bet lawmakers would expand the program with little or no opposition. Now, however, state officials have learned that due to some erroneous assumptions made in regard to the state pension plan, lawmakers will have to find $40 to $80 million more each year to fund new, higher retiree benefits passed in the 1998 session.

Messing with state retirees' benefits is political poison, so it's unlikely legislators will try to take back any of what they granted last session. Instead, as state Sen. Robert Neall, R-Anne Arundel, said, there'll just be less money for everything else.

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The health-care program is a relative bargain for Maryland, because it draws $2 in federal money for every dollar the state puts in. It will cover those 60,000 children for a year for $74 million, $29 million of which will be state money.

Is it possible to do more? It's hard to tell now. Those children who benefit have parents who work at jobs which don't provide health benefits for their employees, or salaries high enough to obtain health insurance privately. But new income tax revenue from those who've never been in the work force before should offset some of the costs.

Another possibility: using some of the state's share of the $4.2 billion tobacco settlement, or the more controversial step of requiring those whose income reaches 185 percent of the poverty level to pay an insurance premium.

At some point, we agree, some recipients will reach the point where they can afford to pay something for their children's care. But with the memory of the latest pension foul-up still so fresh, let's make certain that collecting those premiums won't cost more than it yields, or worse, that some parent's unwillingness to pay won't cost a child needed care.

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