States would get about $900 million in federal funding over five years to pay for efforts to enroll children in Medicaid and new state insurance subsidy programs, under President Clinton's upcoming budget proposal.
In his fiscal 1999 budget proposal to be released this week, Clinton will propose about $540 million over five years to be used by states for expanding outreach to schools, child-care referral centers and child-support enforcement bureaus.
Those locations would be used to temporarily enroll children in Medicaid while their applications were being evaluated, a process known as "presumptive eligibility." An estimated 3 million of the more than 10 million uninsured children are eligible for Medicaid but not enrolled.
Those Medicaid-eligible children are the fastest-growing group of uninsured children, according to one analyst (See related story, p. 44).
The budget proposal also would add $340 million to an existing $500 million fund for all children's health insurance activities. The plan would enable states to access the fund, which previously had been restricted to activities related to enrolling Medicaid-eligible children who are no longer covered because their families have lost cash assistance under welfare reform.
The funding comes on the heels of enactment in last year's federal balanced-budget law of a new child health insurance program. That program is expected to provide state grants worth nearly $40 billion over 10 years for expanding children's health insurance coverage, either through Medicaid or a separate state insurance program.
Reaching children is considered to be an important component to the success of the new program. But the law caps at 10% the amount of children's healthcare expenditures that states can use for outreach, administrative activities and direct purchase of healthcare services.
The Congressional Budget Office last week estimated about 2.3 million children will be covered by state-subsidized insurance programs annually after 1999. The number of children enrolled in Medicaid will grow from 21.7 million this year to 23.3 million in 2002.