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Ehrlich cuts health care for children of immigrants

THE BALTIMORE SUN

The Ehrlich administration has begun sending letters to thousands of low-income legal immigrants informing them that their children will lose health care benefits next month, and officials are deciding whether to restore funding to help pregnant women, as demanded by the legislature.

Gov. Robert L. Ehrlich Jr.'s budget proposal for the fiscal year that begins July 1 eliminated a $7 million Medicaid program for children and pregnant women in low-income families who are legal permanent residents, about 4,000 people statewide. Earlier this year, legislators attempted to restore $1.5 million to cover pregnant women, but Ehrlich spokesman Henry Fawell said yesterday that the administration has not decided whether to comply with the request - which was written into the state budget.

The fate of the program is wrapped up in an intensifying dispute between the legislature and the governor about the General Assembly's budget powers. The confrontation erupted last week in controversies about whether the administration would fund programs such as the state's prevailing wage office and Challenge Grants that aim to improve test scores and behavior in struggling schools.

Yesterday, Montgomery County Executive Douglas M. Duncan, an all-but-declared candidate for governor in 2006 whose county has the largest concentration of immigrants in the state, called the idea of cutting health care for pregnant women "unconscionable" in a sharply worded letter to the governor.

Duncan spokesman David Weaver said there appears to be little hope for the program, which helps between 300 and 400 women in Montgomery County. Statewide figures were not immediately available for the program late yesterday.

"We know the administration has already made a decision to throw thousands of children off the state health care rolls," Weaver said. "We have no confidence they are going to continue funding health care for pregnant women. They have a terrible track record concerning health care in general, and they have a particularly troublesome track record when it comes to state support for the working poor."

Unique powers

The Maryland Constitution gives the state's governor what many say are the strongest budgetary powers in the nation. The Assembly has the power to cut from the governor's spending proposal but cannot add to it or transfer money from one program to another.

The legislature has attempted to get around those restrictions by cutting money from an agency's budget and stipulating that it can be spent only on a particular program, usually one the governor cut or eliminated in his budget proposal.

The practice isn't new, but Ehrlich administration officials have complained that it was used much more frequently this year than in the past - during a time of divided government and when tension between the executive and legislative branches is at its highest level in decades.

"The legislation says something to the effect of 'The $1.5 million shall only be spent on that service,' but obviously they can't require it," Fawell said.

Duncan's letter, which incorrectly implies that the $1.5 million would also restore services to children under the program, seeks to shift the focus from a power struggle between the executive and legislative branches and to return attention to the people who depend on the program.

"It is unconscionable that you would even consider ending state support for pregnant women and children. The social safety net in Maryland has already been frayed by your Administration, and this action seeks to tear it apart entirely," Duncan wrote in the letter, which was also signed by Montgomery County Council President Tom Perez and Councilman George Leventhal.

Del. Ana Sol Gutierrez, a Montgomery County Democrat and native of El Salvador, said it would be "wrongheaded and mean-spirited" to cut the program, which she said would save the state money in the long run by preventing birth defects associated with poor prenatal care.

"This population is one that doesn't vote and is not even going to be able to protest in any way, shape or form," she said. "They are a constituency that is really silent, and that makes it even worse."

Olivia Carter Pokras, an associate professor in the epidemiology and preventive medicine department at the University of Maryland School of Medicine, said Latino women would be hit hardest by the cut because they have the lowest rates of insurance coverage in the state.

"Ability to pay is the biggest barrier to access in care, and restricting access to insurance and coverage to pregnant women poses an increased risk to adverse birth outcomes," she said. "This is not the place to cut."

Duncan implored the governor to comply with the legislature's requests to restore other cuts, such as adult literacy and senior citizen meal programs.

"If these cuts are allowed to stand, thousands of Marylanders will be denied health care, adult education, meals and family support services," Duncan and the councilmen wrote. "In a State as prosperous as ours, surely your Administration can find the resources to help those who need help the most."

Spending review

Many of the cuts in Ehrlich's budget proposal, which was released in January, stemmed from a systematic review of state expenditures that was designed to focus money on high-priority programs and those that provide the biggest return on the state's investment.

The exercise, known as "strategic budgeting," was part of the governor's attempt to grapple with large gaps between the state's projected revenues and expenditures.

But the state's latest fiscal projections show a healthy surplus for the end of this year and more manageable deficits in the future, leading legislators to question the governor's motives for refusing to restore some of the cuts.

Last week, the administration agreed to maintain five prevailing wage inspectors after a General Assembly lawyer found a 1997 law requiring it. But the administration is going forward with cuts to other programs, such as enforcement of the minimum wage and child labor laws.

Fawell said the cuts to the immigrant health care programs should be taken in context.

Ehrlich increased Medicaid funding overall by 9 percent this year, and the program serves 650,000 Marylanders, 40,000 more than when the governor came into office, Fawell said.

Sun staff writer Kelly Brewington contributed to this article.

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