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  • Gilmore vetoed the insurance plan April 7.

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  •   Health Care Compromise Forced in Va.

    Gov. Gilmore and Del. Rollison /AP
    Gov. James S. Gilmore III, right, and Del. John A. "Jack" Rollison III (R-Prince William) joke as Gilmore prepares to sign a Northern Virginia transportation bill. (AP)
    By Spencer S. Hsu and R.H. Melton
    Washington Post Staff Writers
    Thursday, April 23, 1998; Page A01

    RICHMOND, April 22—A defiant General Assembly forced Gov. James S. Gilmore III today to use the federal Medicaid program to provide health care coverage to 83,000 uninsured poor children -- a plan the first-year governor has derided as a "massive welfare expansion."

    Gilmore (R) realized early in the day that he didn't have enough votes to pass his less-generous version of the health care plan, which would have relied on private insurers instead of Medicaid. But rather than end his inaugural session with no health insurance at all for poor children, Gilmore backed down and said he would implement a hybrid of his approach and the legislature's.

    "I have not and will not treat uninsured kids as a political football," Gilmore said in a letter to lawmakers. "I will implement a child health insurance program consistent with" the General Assembly's package.

    The state Democratic Party chairman, Del. Kenneth R. Plum (Fairfax), called the letter a "white flag" of surrender on "a defining issue."

    "I think he's blinked," Plum said. "We ought to applaud the governor for doing that."

    For Gilmore, today's one-day session to consider his vetoes and amendments included repeated rebuffs from moderate and senior Republicans, who defected from the governor's position on children's health and several top education priorities.

    For instance, the House rejected, 59 to 38, Gilmore's attempt to dictate details of how his car-tax rollback will be enacted this year and next. The House also voted down, 67 to 30, his formula for distributing $110 million in school construction money among school districts.

    Instead, General Assembly committees will take up both measures Thursday, when the legislature begins a special session to consider those two big-ticket budget items. The $447 million for the car-tax cut and the money for the school construction were included in the budget adopted in March, but the legislature failed to agree on key details.

    Gilmore's tough day didn't hinge on how lawmakers treated his vetoes: They were able to override only one of 27, and that reversal came on a technical question. The bad news for the governor came in how both Houses treated many of the 127 amendments he had tacked on to their legislation.

    Republicans control the Senate and share power in the 100-member House for the first time, but they were as assertive as Democrats in resisting some of Gilmore's revisions.

    "He had too many amendments. A lot were ill-conceived," said Del. Vincent F. Callahan Jr. (R-Fairfax), co-chairman of the Northern Virginia delegation.

    Del. John A. "Jack" Rollison III (R-Prince William) observed that in the divided General Assembly, neither party could force its way on any issue, as each learned in the recent record-breaking 63-day session. "Today was a whirlwind tour of the last session -- with the same results," Rollison said.

    Lawmakers rejected Gilmore's attempt to hire 2,000 additional elementary school teachers, choosing to adhere to a $66 million plan to hire 600 more teachers and allow districts to use some of the money for salaries to pay as many as 1,400 teachers who are already in the classroom.

    The Senate also refused Gilmore's efforts to toughen a bill that would allow local districts to create two semi-independent charter schools. Gilmore wanted to give groups the option of suing school districts if they were turned down in proposing a charter school, but Republicans joined Democrats in rejecting that change.

    Gilmore fared better on two other education issues.

    The House and Senate failed to override Gilmore's veto of a bill to make sex education mandatory in Virginia's public schools.

    And it appears that Gilmore will be able to veto a bill that would require guidance counselors in elementary schools. Republicans joined Democrats in both houses to reject a Gilmore amendment that would have made the counselors optional for schools, but neither chamber did so by a veto-proof, two-thirds majority.

    Gilmore, meeting with reporters at the end of the day, said he was "generally pretty happy" with the results, adding that the bruising he took on some issues was only part of the natural give-and-take with the legislature.

    On children's health care, Gilmore said he didn't cave in but acted sensibly to break a standoff. "Blink? No, indeed."

    Neither side had scored a clear victory in the day's voting on that measure. The Senate fell one vote short of overriding Gilmore's veto of the Democrat-led initiative. But lawmakers also rejected Gilmore's less comprehensive version of the plan.

    Gilmore said he will move forward with a modified version of the legislature's plan anyway, relying on language in the state budget that lawmakers adopted in March and that Gilmore signed two weeks ago.

    The bill says that starting July 1, "the existing Medicaid program shall be expanded to cover children ages 0 through 18, in families with incomes up to 150 percent of the federal poverty level," or about $24,000 a year for a family of four.

    Families making up to 185 percent of the poverty level, or $32,000, would receive similar benefits but would make co-payments for doctor visits and pay partial premiums. The program would cost $37 million in state money plus $56 million in federal funds. The program would cover about 10 percent of Virginia's uninsured population of 820,000 people.

    Gilmore said that he would accept the approach but that he would keep fighting for the principle that expanding Medicaid encourages welfare dependency, and he said he will look for ways to involve private insurers as well as Medicaid.

    With Gilmore's decision, Virginia becomes the 23rd state to enter a federal program passed in 1997 that offers matching money for states that provide child health insurance. Eleven of the states rely on Medicaid, five created independent state programs and six others created hybrid programs of the sort that Gilmore now supports, according to the National Conference on State Legislatures.

    Aides said Gilmore was partly motivated by fear that opponents would paint his administration as extreme if it failed to insure poor children.

    Still, Democrats and a coalition of 109 child advocacy, medical, labor and religious groups that lobbied for the Medicaid-style program viewed the governor's action as a retreat.

    "It's an exciting time for the children of Virginia," said Jane N. Kusiak, executive director of the Joint Commission on Health Care, a legislative arm that drafted the program.

    © Copyright 1998 The Washington Post Company

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