Medicaid: Ensuring that Noncustodial Parents Provide Health Insurance Can Save Costs
HRD-92-80
Published: Jun 17, 1992. Publicly Released: Jul 24, 1992.
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Highlights
Pursuant to a congressional request, GAO evaluated state and federal efforts to ensure that noncustodial parents with available health insurance resources cover their Medicaid-eligible children.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| Congress should require, as a condition of federal participation in their child support programs, that states enact laws enabling the programs to enforce health insurance requirements on employers, such as is done with income withholding for cash support. | Section 13623 of the Omnibus Reconciliation Act of 1993 requires that, effective April 1, 1994, states are to enact specified laws to ensure the compliance of insurers and employers in carrying out a court or administrative order for medical child support. | |
| Congress should amend ERISA to give states the authority needed to ensure that their medical support efforts can be effective. | The Omnibus Budget Reconciliation Act of 1993 implemented this recommendation. |
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | The Secretary of Health and Human Services should direct the Office of Child Support Enforcement to improve state efforts to establish noncustodial parents' medical support obligations by specifying in program guidance the minimum steps and time frames that states must meet to monitor and enforce medical support obligations. |
Because HHS has agreed to develop outcome-oriented performance standards for medical support activities and monitor compliance, this recommendation--which was made as an alternative to the action HHS has agreed to take--is no longer applicable.
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| Department of Health and Human Services | The Secretary of Health and Human Services should direct the Office of Child Support Enforcement to improve state efforts to establish noncustodial parents' medical support obligations by developing outcome-oriented performance standards for medical support activities and monitoring whether these standards are met. |
While HHS amended its child support audit regulations (at "Federal Register" Volume 59, No. 256, December 23, 1994) to include audits of medical support requirements, it has not changed the requirements for medical support activities since February 1991. Without changing the actual medical support requirements--i.e., laying out specific enforcement steps or performance standards that ensure that enforcement is accomplished, the extent to which the audit requirements ensure that something gets done in medical support is still questionable. Currently, the requirement is still worded "take steps to enforce...".
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Topics
Child custodyChild support paymentsstate relationsHealth care programsHealth insurance cost controlIntergovernmental fiscal relationsIntergovernmental relationsSingle parentsState-administered programsMedicaid