[Congressional Record Volume 144, Number 41 (Thursday, April 2, 1998)]
[Extensions of Remarks]
[Pages E562-E563]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         THE MEDICAID CHILD ELIGIBILITY IMPROVEMENT ACT OF 1998

                                 ______
                                 

                            HON. KEN BENTSEN

                                of texas

                    in the house of representatives

                        Wednesday, April 1, 1998

  Mr. BENTSEN. Mr. Speaker, I rise today to introduce legislation, the 
Medicaid Child Eligibility Improvement Act of 1998, to help more 
children obtain the health care they need through Medicaid. There are 
currently three million children in our nation who are eligible for 
Medicaid but are not receiving the care they need because they are not 
enrolled in the program.
  This legislation would allow public schools, child care resource and 
referral centers, Childrens' Health Insurance Program (CHIP) workers, 
and child support agencies to make the preliminary decision that a 
child is eligible to enroll in Medicaid so that they can receive 
coverage while waiting for a full Medicaid eligibility determination. 
Schools and these other agencies are on the front lines of caring for 
children and can help to educate their families and enroll them in 
Medicaid.
  Under the Balanced Budget Act enacted last year, States received a 
new option under Medicaid to grant ``presumptive eligibility'' to 
certain children on a temporary basis as their

[[Page E563]]

Medicaid eligibility is determined. My legislation would expand this 
presumptive eligibility option to make it more flexible and attractive 
to the States. The presumptive eligibility period is normally sixty 
days and gives States sufficient time to complete the Medicaid 
eligibility determination process. If a state ultimately determines 
that the child is not eligible for Medicaid, none of these entities 
would be penalized or lose funding due to a negative determination. 
Under this legislation, we would be enrolling children on an expedited 
basis and could reach some of those three million children who are 
eligible but not enrolled.
  While some would argue that there will be a cost associated with 
increasing participation in the Medicaid program, it is important to 
remember that when Congress enacted Medicaid, it assumed that these 
children would be covered. I would argue that adding these children is 
not only morally right, but also cost-effective in comparison to 
letting these children receive health care on an ad hoc basis. Many of 
these children will simply go to hospital emergency rooms for treatment 
and will not be able to pay for these services. In the end, we will pay 
the cost. With Medicaid coverage, our public institutions will be 
reimbursed and these children will receive better care through primary 
care providers instead of high-cost, emergency-care based services.
  This legislation is also fiscally responsible in that it would 
require a state to deduct from their state allotment any funding used 
for this program. I believe that the small cost associated with this 
outreach effort will not adversely impact States' ability to provide 
health care for low-income children and in fact could reduce the 
States' disproportionate share expenditures.
  We know that these children are not being properly served now and we 
must find innovative way to ensure that all eligible children are 
enrolled in Medicaid. My legislation would simply accelerate the 
application process while maintaining sufficient safeguards to prevent 
fraud and abuse. My legislation would give States greater flexibility 
to determine which entities can make these determinations, and States 
are authorized to apply certain limitations in order to prevent fraud 
and abuse. My legislation would also permit the Secretary of the Health 
and Human Services to review States' decisions and ensure that the 
appropriate entities are allowed to enroll these children. None of 
these entities could immediately offer these services until their state 
and the federal government has deemed them to be eligible to undertake 
preliminary determinations.
  I believe this is an important public policy matter which we need to 
address. My legislation would enroll more children in Medicaid while 
ensuring that appropriate entities are reviewing the applications. I 
believe it is more cost-effective to enroll these children and ensure 
that they are receiving the primary care services they need, rather 
than sending these children to emergency rooms where they will be 
sicker and taxpayers will end up paying more. I also believe that we 
need to improve our current Medicaid presumptive eligibility law by 
including these new entities which were not included in the Balanced 
Budget Act. I strongly urge my colleague to support his critical 
legislation.

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