State lawmakers filed hundreds of would-be laws on Monday, including proposals to create a health insurance program for children who have a parent paying child support, strengthen background checks for people who work with the elderly, and require women who seek an abortion to first get an ultrasound.

It was the first day bills could be filed for the legislative session that begins in January.

Although filing a bill is just the first step in a long process (of about 6,200 bills introduced in 2007, only about 1,500 passed) the filings offer a glimpse of what lawmakers will be debating.

State Sen. Jane Nelson, R-Lewisville, chairwoman of the Senate Committee on Health and Human Services, said that Texas is faring better financially than many states but that its budget will be tight because of "a growing price tag for Hurricane Ike" and rising costs of Medicaid, the federal-state health insurance program for low-income people and those with disabilities.

"We need to spend every penny wisely," Nelson, a member of the Senate's budget-writing team , said in a statement.

Nelson proposed establishing a health insurance pool for children whose child support cases are tracked by the attorney general's office. As many as 500,000 of the 1.3 million children lack proof of health insurance, despite state and federal requirements that the parents provide medical support, she said. Parents, not the state, would pay for insurance under the program.

Nelson also proposed requiring that people who work with elderly and disabled people — such as employees of nursing homes, assisted living facilities and institutions for people with mental retardation — undergo fingerprint-based background checks. Criminal background checks, but not fingerprint-based searches, are now required for many of these jobs.

"Technology has reached the point where we should not have individuals with serious criminal histories falling through the cracks of our background checks, especially those working with children, seniors and the disabled," Nelson's statement said.

Meanwhile, state Sen. Bob Deuell , R-Greenville, and others are reviving a proposal to legalize needle-exchange programs, a bill that was passed by the Senate in 2007 but died in a House committee.

Texas is the only state that does not allow programs that give clean syringes to drug addicts, said Deuell, a doctor and the vice chairman of the Senate Committee on Health and Human Services. A San Antonio-area pilot needle-exchange program authorized by the Legislature in 2007 faced local opposition and never got off the ground.

Opponents of such programs say that they encourage use of illegal drugs, but Deuell said medical research shows that they do not.

"It cuts down on hepatitis B and HIV; it gets people into rehab," he said.

Deuell is also proposing allowing certain children with disabilities to join Medicaid. Now, he said, parents who work risk earning too much for their children to qualify. His program would allow them to stay in the program by paying a premium.

"If they work to better themselves, they lose the health care, and the kid literally, without exaggeration, dies," Deuell said. "Let these people work."

The ultrasound proposal, by Sen. Dan Patrick , R-Houston and state Rep. Frank Corte Jr., R-San Antonio, would require women who seek an abortion to first have an ultrasound — although they would not be required to view the image — and to listen to the fetal heartbeat.

"Once an ultrasound is performed, and a woman sees it, she may decide to change her mind and not have the procedure," Patrick said, "and that's a wonderful thing, if that woman decides to keep that baby or put it up for adoption."

A similar proposal passed the Senate last year but stalled in the House.

With Democrats gaining more seats in the House, the ultrasound bill's chances might be even worse this time, said Sherri Greenberg , a fellow at the Center for Politics and Governance at the LBJ School of Public Affairs.

Last week's elections gave the House 76 Republicans and 74 Democrats, but as election officials continued to count ballots in one North Texas race, the balance of power, choice of House speaker and fate of all legislation remains in question, said Greenberg, a former state representative. "Things are very much in the air."