Kids' Health Insurance Plan Moves Forward
26 03 08 - 12:15
The Maryland House of Delegates agreed yesterday to encourage more working-poor families to enroll their children in a state health insurance program but stopped short of mandating enrollment and withholding tax credits from parents who don't sign up.
The issue of mandatory health insurance is roiling state legislatures and the race for the Democratic nomination for president between Sens. Hillary Rodham Clinton (N.Y.) and Barack Obama (Ill.). In Maryland, despite almost a decade of marketing efforts by state government and social service agencies, nearly 90,000 children eligible for subsidized health insurance are not enrolled. Another 40,000 whose parents have higher incomes lack private insurance.
This hard-to-reach population is the focus of the Kids First Act, which won preliminary approval in the House. The state would use the annual rite of income taxes to begin to identify which children are uninsured and encourage their parents to enroll them in subsidized plans.
"This is breaking a barrier down and putting an application in the hands of a family," said Del. Heather R. Mizeur (D-Montgomery), the bill's lead sponsor. About 470,000 children younger than age 19 are receiving subsidized insurance in the current fiscal year.
The state comptroller's office would take the lead in communicating with parents at tax time. Starting in the fall, parents with incomes up to three times the federal poverty line -- $42,000 for a family of two and $74,400 for a family of five -- would receive a notice with their state income tax forms telling them they are eligible for the Maryland Children's Health Program.
The next year, the forms would contain a box asking parents to designate whether their children have insurance or have had a lapse in coverage of 63 or more days in the preceding year. Qualifying families would receive an enrollment application and literature about the program in the mail.
Stripped from the bill in committee was an intriguing stick for parents who did not eventually enroll their children: disqualification from claiming a child deduction on their state income tax.
The mandate was praised by health advocates and social service organizations at a hearing this month. But legislative leaders said that it might have unfairly punished parents who don't sign up their children because of language obstacles or discomfort with accepting government help. The child tax deduction can be worth thousands of dollars.
"I did not want to start out with the stick approach," said Del. Peter A. Hammen (D-Baltimore), Health Committee chairman. "But at the end of the day, we can certainly come back to it. . . . Just notifying them might be enough."
Maryland ranks 31st in the nation in the number of uninsured children, at 10 percent, Mizeur said.
The Kids First Act leaves open the possibility of a mandate. If more than 3 percent of children remain uninsured in Maryland by 2010, state health officials will study a program that disqualifies parents for the child tax exemption. The measure also calls for another study of how to make health coverage more affordable for children whose parents earn too much for subsidized insurance but too little to afford premiums, particularly if they are self-employed.