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OCR Page 1 of 67THE WASHINGTON POST WEDNESDAY, APRIL 15, 1998
Mismatch on Children's Health
N SETTING UP a new children's health
children currently eligible for Medicaid re-
I
program last year, Congress rightly tried
ceive it. The data are such that no one can be
to make sure that it would benefit those in
sure of the number; the study says it could be
genuine need. The money could be used only
anywhere from 1.6 million to 4.7 million.
for children from families below certain in-
These children are currently insured only in
come levels-in most cases, twice the federal
theory. Perhaps some of the money from the
poverty line. Within that income group, it was
new program could be used to induce the
further limited to those not already eligible for
states to cover them in fact, the study sug-
Medicaid or covered by private insurance. The
gests-help pay the state share of enrolling
goal was to reduce the number of children
them in Medicaid.
without insurance rather than bail out the
But the authors note that even that is an
states or private employers by picking up
uncertain device, since in the poor states in the
premiums for children already insured.
South and elsewhere that tend to have high
The targeting was commendable, but now it
concentrations of uninsured children, the fed-
turns out it may have been overdone. A study
eral government even now pays an extra-high
by scholars at the Urban Institute says there is
share of Medicaid costs. If that hasn't already
money enough in the program-about $24
induced the states to broaden their Medicaid
billion over five years-to insure about twice
programs, how much difference are a few
as many children as the rules leave eligible.
percentage points more likely to make?
The money is estimated to be enough to insure
There are millions of uninsured children in
almost 6 million; the number eligible is not
the country, and there is money enough in this
much more than 3 million. The risk is that if
program to cut the number by more than half.
the rules aren't sensibly eased, the program
The trick is in matching the money to the kids.
will end up doing a lot less good than it either
It's too early to be completely sure, but the
could or should.
administration and Congress may want to go
A major part of the problem is that not all
back to the drawing board on that.
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