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Office of the Press Secretary

For Immediate Release January 11, 2000


                        IN THE STATE CHILDREN'S
                        HEALTH INSURANCE PROGRAM
 Unveils New Initiative to Finish the Job Enrolling Uninsured Children
                            January 11, 2000

Today, the Clinton-Gore Administration will release a new report by the Department of Health and Human Services documenting that 2 million children have now been enrolled in the new State Children's Health Insurance Program (SCHIP), doubling the program's enrollment in less than a year. The White House will also unveil a new, multi-faceted proposal that will be included in the President's FY 2001 budget to accelerate enrollment of uninsured children in Medicaid and SCHIP. This initiative will invest $2.7 billion over the next five years to: (1) provide new options to find and enroll uninsured children through schools; (2) allow additional sites such as child care referral centers to immediately enroll low-income, uninsured children while their applications are formally processed; (3) require states to make their Medicaid enrollment as simple as that of SCHIP; and (4) expand Medicaid to include an option to cover children through age 20 and extend the same option to SCHIP. Together, these steps will help states finish the job of enrolling uninsured children in Medicaid and SCHIP.

NEW REPORT SHOWS THAT 2 MILLION CHILDREN ARE NOW ENROLLED IN SCHIP. Today, HHS is releasing a state-by-state report on SCHIP enrollment and implementation. Created in 1997, SCHIP enables states to cover children from working families whose incomes are too high to qualify for Medicaid but too low to afford private health insurance. This expanded coverage can be achieved through Medicaid expansions, a separate state program, or a combination of both strategies.
As states continue to expand their programs, this report shows that great progress has already been made in enrolling children. Highlights include:

The number of children enrolled in SCHIP has doubled in less than a year. Nearly 2 million children were served by SCHIP between October 1, 1998 and September 30, 1999, a doubling in enrollment from December 1998.

The number of states covering children up to 200 percent of poverty has increased by more than seven fold. In March 1997, only 4 states covered children with family incomes up to at least 200 percent of the Federal poverty level (about $33,000 for a family of 4). Today, 30 states have plans approved to cover children with incomes up to at least this level.

MORE NEEDS TO BE DONE TO FINISH THE JOB. Despite these positive enrollment trends, millions of children remain eligible for Medicaid or SCHIP. Reasons why children remain uninsured include:

Lack of awareness of eligibility. Many parents believe that working or not receiving welfare disqualifies their children from Medicaid or SCHIP. Others do not know about SCHIP, which targets families that typically do not qualify for other public programs.

Lack of coordination between programs. A recent study by the Urban Institute found that approximately 60 percent - almost 4 million - of the uninsured children nationwide are currently enrolled in school lunch programs. However, Federal law prohibits these programs from sharing enrollment information with Medicaid.

Difficult enrollment process. While states, the Administration and Congress have made it significantly easier for parents to enroll their children, barriers remain. These include confusing applications with complicated paperwork requirements; some states' requirement for in-person interviews, often at inconvenient times and places; different processes within states for Medicaid and SCHIP applications; and Federal statutory limits on where Medicaid eligibility can be established on a "presumptive" basis (e.g., most schools are disqualified).

CLINTON ADMINSTRATION UNVEILS NEW INITIATIVE TO HELP STATES FINISH THE JOB OF ENROLLING UNINSURED CHILDREN IN MEDICAID AND SCHIP. Today, The White House will unveil a new, five year, $2.7 billion investment in children's health outreach that will be included in the Administration's FY 2001 budget. This initiative will:

Provide new options to find and enroll uninsured children through schools. This proposal, similar to bipartisan legislation proposed by Senator Lugar (S. 1570), would allow school lunch programs to share application information with Medicaid staff for the sole purpose of outreach and enrollment (this is already allowed for SCHIP). It would also allow states to use enrollment in school lunch programs as the basis for presumptive eligibility for Medicaid and/or SCHIP. This means that qualified entities, at the states' discretion, may immediately enroll potentially eligible children in Medicaid and SCHIP on a temporary basis while their applications are formally processed.

Allow additional sites, like child care referral centers, to help bring kids into SCHIP and Medicaid. The President's proposal also gives states added flexibility to use additional sites, beyond schools, to determine presumptive eligibility: child care centers, homeless shelters, agencies that determine eligibility for Medicaid, TANF, and SCHIP, and other entities approved by the Secretary. This option can help states provide critical health care services to children pending official enrollment and increases the likelihood that families will complete the application process.

Require states to make their Medicaid and SCHIP enrollment equally simple. Complicated, long application processes for Medicaid and SCHIP discourage enrollment. While many states have recognized this and have simplified the process in SCHIP and Medicaid, not all states have carried over all of their simplification strategies to Medicaid. To ensure that children do not fall through the cracks in states that have different rules and procedures for Medicaid and SCHIP, this proposal would require that states conform certain Medicaid eligibility rules and procedures for children to the rules and procedures used in SCHIP. If a state, in SCHIP: (1) does not require an assets test; (2) uses simple eligibility requirements and a mail-in application; and (3) determines eligibility for SCHIP no more than once a year, it would need to apply these same rules and procedures for children in Medicaid.

Expand Medicaid to include an option to cover children through age 20 and extend the same options to SCHIP. Currently, states have the option to extend Medicaid eligibility to some children through age 20. This proposal would allow states the same flexibility for SCHIP and for all other Medicaid children, helping them cover people in one of the most vulnerable age groups; the highest uninsured rate -- 30 percent -- is for people ages 18 to 24 years old.

BUILDS ON THE CLINTON-GORE ADMINISTRATION'S LONGSTANDING COMMITMENT TO CHILDREN'S HEALTH. President Clinton and Vice President Gore have a long standing commitment to children's health -- and to ensuring that children eligible for insurance know about it. In 1998, the Clinton-Gore Administration, together with the National Governors Association and private sector partners, launched a nationwide "Insure Kids Now" Outreach Campaign that established a national toll-free number for children's health insurance outreach (1-877-KIDS NOW or 1-877-543-7669) and a website ( In 1999, the Administration launched a major back-to-school children's health outreach campaign that enlisted over 1,500 schools to conduct local outreach activities. The Administration supported and, with bipartisan Congressional support, passed an extension of the TANF $500 million fund for outreach, providing states with resources to conduct aggressive education campaigns. It has promoted the use of a single, simple joint application for Medicaid and SCHIP; encouraged states to make Medicaid and SCHIP easy to enroll in and user-friendly; and created an Interagency Task Force on Children's Health Insurance Outreach that coordinates outreach actions for over 10 Federal agencies. In addition, the Administration has targeted hard-to-reach populations like rural children and legal immigrant children, by clarifying regulations so that enrolling in Medicaid or SCHIP and receiving other critical benefits will not threaten their immigration status.