Medicaid and Children's Insurance

Pursuant to a congressional request, GAO provided information on how proposed changes to Medicare will affect children, focusing on: (1) recent trends in children's health insurance coverage; (2) whether states have expanded coverage for children beyond federal requirements; and (3) the experiences of state-funded non-Medicaid programs in providing health insurance for children. GAO noted that: (1) as employment-based insurance in the United States has declined, Medicaid has become the primary insurer for poor children; (2) 13.7 million children were covered by Medicaid in 1993; (3) most Medicaid expansions for children were due to federal mandates, not to state actions; (4) although 37 states and the District of Columbia expanded eligibility for Medicaid beyond federally mandated levels only 21 states had expanded eligibility for children beyond the federal mandated levels; (5) current proposals to change Medicaid would limit federal fund growth, eliminate some federal eligibility requirements and required services, and reduce the amount of funding required for low-income families; (6) although state-funded programs have more limited benefit coverage than Medicaid, they often cover preventive and primary care services and prescription drugs; and (7) without accompanying changes in the health insurance market that encourage employers to provide or families to purchase dependent coverage, the proposed changes to Medicaid could increase the number of uninsured children in the future.