White House criticizes states' failure to expand children's health coverage

Clinton to announce federal audit of Medicaid enrollment, eligibility


WASHINGTON -- President Clinton will send federal officials to all the states to investigate whether they have improperly excluded people from Medicaid or from a new federal health insurance program for children, White House officials said yesterday.

At the same time, he will try to get schools across the country to help arrange health coverage for millions of uninsured children.

Clinton plans to announce the efforts today when he addresses the 91st annual meeting of the National Governors' Association in St. Louis.

In his speech, the officials said, Clinton may take a more confrontational approach than usual in discussions with the governors.

"States now have an unprecedented opportunity to expand health coverage, and they should make the most of it," said Bruce Reed, the president's chief domestic policy adviser.

When Congress created the Children's Health Insurance Program in 1997, it gave the states billions of dollars -- $24 billion over five years, more than $39 billion over 10 years -- and considerable flexibility in how the money could be used. In addition, White House officials noted, states are getting billions more from the settlement of lawsuits against tobacco companies, money that is available for children's programs.

So far, only 1.3 million children have been enrolled in the new health program, the administration says. Clinton said recently that he would have expected at least 3 million by now, and that he was therefore "a little disappointed."

Clinton will also try to enlist the governors in his campaign against tax and spending policies of the Republican Congress. He will argue that the tax bill passed last week by Congress would not only use up all the anticipated surpluses in the federal budget, but also threaten federal-state programs such as welfare, Medicaid, education and social services, administration officials said.

Confidential White House documents show that Clinton will instruct the Health Care Financing Administration to review state Medicaid enrollment and eligibility processes in all states. Federal officials will interview state officials and check case files to "assess compliance with current laws and develop recommendations for improvements."

Reed said a major purpose of the audit was "to find out more information about what's going on in each state."

Tomorrow, White House officials said, the Education Department will send letters to 15,700 school superintendents and 27,000 elementary school principals, prodding them to help enroll children in Medicaid and in the Children's Health Insurance Program.

"A staggering 11 million American children and teen-agers have no health insurance," said Education Secretary Richard W. Riley on a new Web site created to promote the administration's efforts.

In his letter, Riley says that more than 6 million of these children are eligible for Medicaid or the new health program but have not been enrolled.

Uninsured children are more likely to suffer from asthma, ear infections and vision problems -- "treatable conditions that interfere with classroom participation" -- and they are absent more often than their peers, Riley said.

White House documents show that the Clinton administration will urge schools to take these steps to enroll children in the two programs:

Make enrollment part of the school registration process. Add a question to school enrollment forms asking whether students have health insurance.

Use the school lunch application form to see if children are eligible for subsidized health insurance and even to enroll them in the health programs. "Children who are eligible for free and reduced-price school meals are usually eligible for free or low-cost health insurance programs" too, the Education Department says.

Disseminate information on children's health insurance at back-to-school nights, PTA meetings, sports events and school plays.

Make sure all school employees know about children's health insurance programs so they can share the information with students and parents.

Pub Date: 8/08/99

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