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Md. awaits federal action on children's health program

Maryland could get $965 million in new federal money for children's health care over the next five years if Congress reauthorizes an expiring federal program and finds a way to pay for increased spending, according to a report released today by a consumer health group.

Those are big ifs, and children's health advocates say a lot is riding on Congress' decision.

Discussions about reauthorizing the State Children's Health Insurance Program and finding the money for $50 billion above current spending have been brewing for a big debate this summer in Congress. The money would have to come from new revenues or cuts in other areas.

Maryland is one of 14 states experiencing a shortfall this year in its program, said Secretary of the Maryland Department of Health and Mental Hygiene John Colmers. Maryland is due to run out of federal money from S-CHIP later this month.

"Failing to act means that either the state is going to have to cut back coverage for children currently in its program or the state is going to have to pick up this additional money on its own without federal help," said Ron Pollack, executive director of Families USA, which released its report today.

Maryland stands to lose $12.2 million in this federal fiscal year and $23.5 million in the next year, Colmers said.

"That is why the reauthorization is so critically important and certainly why a reauthorization that substantially increases the size of the S-CHIP pie is so important," Colmers said today.

While Democrats in Congress have been pushing for the additional money to cover more children, the Bush administration has argued that families are becoming too dependent on public money for health care coverage. The program is paid for by federal and state governments and is administered by states.

The program would include a financial matching requirement. For every dollar a state puts into the program, the federal government would match $1.86.

Maryland, whose eligibility standard for the program is 300 percent of the federal poverty level, is one of 18 states that allows families to participate above 200 percent of the poverty line. The Bush administration has been pushing to scale back eligibility to 200 percent.

Maryland currently has about 106,000 children in S-CHIP, Colmers said. About 12,000 of them come from families with incomes between 200 percent and 300 percent of the poverty line and pay a family contribution.

Pollack said during a conference call today that he believes there are too many states already above the 200 percent mark for Congress to force them to cut back.

"My best guess is that eligibility with respect to children will not be scaled back," Pollack said.

However, some of those states also extend eligibility to parents, and Pollack said continuing to allow parental eligibility "is going to be a tougher debate in Congress."

The Families USA report was based on data from the Centers for Medicare and Medicaid Services. It's also predicated on the current S-CHIP allocation formula and Medicaid expenditures for children.

The S-CHIP program will expire this year unless Congress renews it before Sept. 30. The program, which began in 1998, was created for children whose families made too much money to qualify for Medicaid but not enough to afford private insurance.

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