UNINSURED CHILDREN: President Calls for State Push, Lauds California’s Efforts
Addressing the 91st annual meeting of the National Governor's Association yesterday, President Clinton announced an impending federal investigation of all states to uncover any improper exclusion of people eligible for Medicaid or the Children's Health Insurance Program (CHIP). In so doing, he took a less confrontational tone than expected, praising several states for their efforts. Gov. Gray Davis said, "The advance billing was that he was going to be critical, but his speech, I thought, was more conciliatory." Clinton singled out California, along with programs in Nevada and Alabama, as exemplary, saying, "Governor Davis is doing outreach for CHIP [called Healthy Families in California] in 10 different languages." He called the enrollment of 1.3 million children "a huge increase in the last six months," adding that the program is "finally beginning to pick up." The San Diego Union-Tribune reports that despite published reports over the weekend, Clinton in fact seemed more concerned with Medicaid than with CHIP. He said, "So this month -- as was reported, I think, already -- we will begin working with you in partnership to do some on-site reviews to ensure that there are no roadblocks -- intentional, or even more likely unintentional ... to those who are eligible for Medicaid." Davis said he was "unconcerned" about possible federal investigations, saying, "All of us expect to be held accountable. ... This is the first full year of funding for the (Healthy Families) program, and I think you will see some dramatic gains in the final six months" (Mendel, 8/9).
The New York Times reported that according to administration officials, the action reflects the president's "disappointment at the way some states have carried out the new health program for children." As part of the investigation, HCFA will "conduct comprehensive on-site reviews of state Medicaid enrollment and eligibility processes" and "interview state officials and check case files to 'assess compliance with current laws and develop recommendations for proper improvements.'" Current practices for enrolling children into the program in states like Nebraska, Ohio and South Carolina will serve as examples for federal officials to help other states improve their enrollment policies. The states were also criticized for not providing information on the number of children enrolled in Medicaid and CHIP, information necessary for Congress to determine the funding for those programs. In a letter addressed to HHS Secretary Donna Shalala earlier this week, seven senators including William Roth (R-DE), Daniel Patrick Moynihan (D-NY), Edward Kennedy (D-MA) and John Chafee (R-RI), expressed concern with the "lack of reliable data" needed to "evaluate whether we have made overall progress in reducing the number of uninsured children," and worrying that some states may illegally be using money earmarked for CHIP to cover children already eligible for Medicaid (Pear, 8/8).
The Washington Post reports that the governors were "animated in their response" to the president's remarks on CHIP, defending their states' respective track records, and seeking to shift the blame back to Washington. According to New Hampshire Gov. Jeanne Shaheen (D), it took a year to receive federal approval to implement her state's program. She said, "All of us feel we have very good stories to tell about what we're doing. This is one where I'm going to disagree with the president." Wisconsin Gov. Tommy Thompson (R) echoed Shaheen's stance, indicating that he waited 18 months for "federal approval of a program far more ambitious than CHIP." Virginia Gov. Jim Gilmore (R) urged the federal government to "do more to provide education and jobs" rather then send "people with green eye-shades and dark glasses from Washington" to determine the status of states' efforts (Balz/Broder, 8/9).
Enlisting Schools' Help
President Clinton will also call on public school officials to help in the effort to provide coverage to uninsured children. The Department of Education will send letters to 15,700 superintendents and 27,000 school principals on Monday soliciting their help. The letter will outline several plans to enroll more children including:
- Making enrollment part of the school registration process by inquiring about a child's coverage.
- Using school lunch program applications to see if children are eligible for subsidized health insurance.
- Providing more information regarding CHIP to school officials.
- Distributing information to parents and the community at school functions.