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Two programs for medical aid given reprieve


ANNAPOLIS -- Conceding he was "affected" by recent protests, Gov. William Donald Schaefer restored funding yesterday to two state medical assistance programs: one that benefits kidney patients on dialysis treatment and another that assists the poor with the cost of medication.

Governor Schaefer took the opportunity of a Christmas Eve news conference to announce the policy reversal. He said he would seek emergency legislation from the General Assembly next month to extend and possibly modify both the pharmacy assistance and kidney disease programs to make them more affordable.

Because of a relatively new wrinkle in the Medicaid funding formula, the cost to continue the two programs -- about $3 million for each -- will be paid by the federal government.

"It's never a pleasure for me to be confronted with decisions that are difficult, that people will be hurt," the governor told reporters at at the State House. "We're being pushed and pulled by the retarded, by the elderly, by AIDS patients, by the poor and the homeless on the street."

Nevertheless, Governor Schaefer said, he was moved by the recent protests organized by those who benefit from the programs.

"One man came up to me, looked me right in the eye, and said, 'If you cut this program, you'll kill me,' " Mr. Schaefer recalled. "They look at me, and I am affected by it."

The state's kidney disease program pays benefits to about 4,000 Marylanders.

The Medicare program finances 80 percent of the cost of dialysis, with the state program contributing the remaining 20 percent.

The pharmacy assistance program benefits more than 14,000 people, including some patients with acquired immune deficiency syndrome who require the drug AZT. The state program helps pay for drugs for low-income individuals who are not eligible for Medicaid benefits.

Both programs were terminated last month by the state Board of Public Works, which was acting on recommendations from the state Department of Health and Mental Hygiene. The kidney program was scheduled to end Jan. 1, and the pharmacy assistance program was set to end April 1.

Under the administration's new proposal, the state will leverage the money from the federal government by charging doctors, pharmacists and other health-care providers a "provider fee" for Medicaid services.

However, the provider fee will be offset by a corresponding increase in the state's half of the Medicaid reimbursement, according to Nelson J. Sabatini, state deputy secretary of health.

The result is no net increase to health-care providers or to the state, but a genuine increase to the federal government.

Governor Schaefer said he did not like the apparent piece of fiscal flimflam but noted that 16 other states had begun doing it. He said the U.S. attorney general had determined it to be legal.

George A. Ward, president of the Maryland chapter of the National Kidney Foundation, called the governor's decision "good news" for kidney patients who needed the help to afford medical treatment.

Mr. Ward said his organization was also willing to support changes in the kidney program -- such as imposing a resource test so that wealthier people would not be eligible for benefits -- to keep costs under control.

"We want them to pare the program back in a reasonable way," said Mr. Ward, a former dialysis patient. "We were most concerned about people who fall through the cracks. For them, this was a life or death issue."

Yesterday's announcement marked the second time in less than two weeks the governor has had to reverse himself on a budget issue.

Mr. Schaefer had proposed laying off 1,800 state workers to counter a projected $423 million state budget deficit, but he changed his mind 11 days ago after state legislators objected.

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