Capital News Service
Wednesday, Oct. 18, 2006
WASHINGTON - Facing a huge budget shortfall, Maryland may be forced to
reduce health coverage for thousands of low-income children unless Congress acts
quickly to close the funding gap, a recent policy study says.
As it stands now, the Maryland Children's Health Insurance Program faces at
least a $64.6 million shortfall and will operate on little more than half of the
federal funding it needs for 2007, according to the Maryland Budget & Tax Policy
At least 16 other states face a collective $900 million to $950 million
funding shortfall in the State Children's Health Insurance Program, a 10-year
federal-state partnership grant, according to the analysis released late last
"Our feeling from the federal government is we're going to get the money,"
said Alonzo Robinson, the program's supervisor at the Maryland Department of
Health and Mental Hygiene.
But depending on the outcome of the Nov. 7 election, health care advocates
aren't so sure that the lame duck Congress will pass the legislation before
adjourning for the year.
"If they don't authorize this money, Maryland is in trouble," said Leigh
Cobb, a health policy consultant for Advocates for Children & Youth.
Last year, the federal government stepped in to address funding gaps, and
Maryland has typically received additional money from a pool of unused funds
from other states.
Those redistributions have been funding the program to a great extent over
the years, but as other states have gotten their programs up and running, the
pot is shrinking, said Henry Fitzer, a deputy budget director with the health
If the bill is not passed this year, the Maryland General Assembly would bear
the burden of coming up with additional funding and the program may have to
resort to capping or freezing enrollment or raising monthly premiums.
"Services could be cut," Robinson said.
In a Sept. 19 letter to President Bush, 12 governors, including Maryland Gov.
Robert Ehrlich, asked Congress to "address the short-term funding shortfall, or
states will be forced to drop children from their programs or move SCHIP
eligible children into already stretched-thin Medicaid programs."
Maryland's program is an expansion of Medicaid. Should the funding fall
through, the state would recover what it could from Medicaid, which only matches
50 percent of health care costs as opposed to the health program's 65 percent.
There would still be a shortfall that the state would have to make up, said
More than 6 million low-income children and pregnant women were enrolled
nationally in 2005. More than 103,000 Marylanders were enrolled in the program
this year, according to the Department of Legislative Services.
To complicate matters, the program is up for re-authorization next year.
Given its funding woes, there is already much discussion about how future grants
should be allocated and whether redistribution among states is an effective
means of funding.
Congress cannot just simply write "a check for $900 million when there's
billions that states are sitting on and not spending," said Becky Shipp, a
Republican aide to the Senate Finance Committee, where the funding proposal is
Senate aides on both sides of the aisle agreed that the fate of the bill
could depend on the Nov. 7 elections.
Sen. Barbara Mikulski, D-Md., is hopeful the bills will advance. She will pay
close attention as the program is re-authorized next year, wrote spokeswoman
Melissa Schwartz, in an e-mail. "She will continue to work closely with members
of the Finance Committee to make sure the Senate is addressing this issue."
Similarly, Rep. Chris Van Hollen, D-Kensington, said it's an urgent issue.
"We're just going to push very hard," to have it be a priority in November, he
But for low-income residents, the threat of diminished services is no
"If you add premiums for low-income people, they drop off the rolls," said
Cobb. "Those are not good options."