A General Accounting Office report yesterday showed that adult coverage under the State Children's Health Insurance Program is causing an undue burden on some states.
The GAO study used fiscal year 2006 information on nine states and found that adults accounted overall for about 54 percent of total SCHIP expenditures.
The report, commissioned by Senate Finance Committee ranking member Sen. Chuck Grassley (R-Iowa), looked at program structure, enrollment and expenditure experiences and outreach approaches.
Grassley and other members of Congress have raised concerns over the use of SCHIP funding spent on adults that was intended for children. Grassley said he hopes the report will provide some insight as reauthorization debates continue. This week Congress passed a bill that would temporarily fund SCHIP until spring 2009.
A Jan. 9, 2007 report by the Kaiser Commission on Medicaid and the Uninsured notes that 74 percent of eligible uninsured children from low-income families are not currently enrolled in Medicaid or SCHIP, but are much more likely to be enrolled if their parents are.
GAO also found that per capita expenditures for parents were on average 82 percent higher than those for children in five of the six states that offered direct coverage to parents.
Debates over SCHIP have raised questions over how states can move parents covered in SCHIP to Medicaid. The report noted that in some cases, states that covered adult populations in SCHIP had previously covered them in Medicaid.
GAO found that states covering adults were more likely to be in shortfall than states that did not cover adults, and the study found that in some cases the expenditures for adults alone exceeded the state's allotment.
Kerry Weems, Acting Administrator of the Centers for Medicare and Medicaid Services said there were a number of ways the report could have been more accurate. GAO counted care for unborn children as care for adults, for example. Weems said CMS "strongly recommends" a review of eligibility used in the report.