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The House of Delegates will debate today a sweeping health care initiative that would be partly funded by a new tax on HMO premiums after the bill was approved by a key committee yesterday.

The plan proposed by Del. John A. Hurson, a Montgomery County Democrat and chairman of the Health and Government Operations Committee, would provide more money for community health centers, refer Marylanders without insurance coverage to those centers and elsewhere, and provide Medicaid coverage to 75,000 more residents by making eligibility requirements less restrictive.

The program would cost $154 million yearly by the 2008 budget year, when it would be fully operating. It would be funded through a 1 percent tax on health maintenance organization policies, as well as additional money from the national tobacco settlement that will be available in four years.

Hurson, whose committee approved the proposal yesterday, said he has begun discussions with leaders in the Senate to prepare it for final legislative approval - a challenge, with 12 days remaining in the Assembly session.

"We are prepared to have a very good conference committee," Hurson said. "We're talking about details. We're already at that point."

Hurson said his plan could save hospitals $26 million a year by directing people without insurance to health centers rather than to emergency rooms for routine care. The program would also expand coverage to the parents of 89,000 children who now receive subsidized care through a popular state program known as the Maryland Children's Health Program.

But Gov. Robert L. Ehrlich Jr. vetoed a bill last year that contained an HMO premium tax, saying the costs would be borne by consumers. He has shown no willingness to reconsider the levy this year.