{
  "id": "RL32135",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "RL32135",
  "active": false,
  "source": "EveryCRSReport.com",
  "versions": [
    {
      "source": "EveryCRSReport.com",
      "id": 104172,
      "date": "2003-11-03",
      "retrieved": "2016-04-08T14:35:17.018544",
      "title": "A Review of Medical Child Support: Background, Policy, and Issues",
      "summary": "Medical child support is the legal provision of payment of medical, dental, prescription, and\nother\nhealth care expenses of dependent children. It can include provisions to cover health insurance costs\nas well as cash payments for unreimbursed medical expenses. According to 2001 Child Support\nEnforcement (CSE) data, 93% of medical child support is provided in the form of health insurance\ncoverage. The requirement for medical child support is apart of all child support orders\n(administered by CSE agencies), and it only pertains to the parent's dependent children. Activities\nundertaken by CSE agencies to establish and enforce medical child support are eligible for federal\nreimbursement at the CSE matching rate of 66%.\n  The medical child support process requires that a state CSE agency  notify  the\n employer of a\nnoncustodial parent who owes child support, that the parent is obligated to provide health care\ncoverage for his or her dependent children. CSE agencies notify employers of a medical child\nsupport order via a standardized federal form called the National Medical Support Notice. The plan\nadministrator must then determine whether family health care coverage is available for which the\ndependent children may be eligible. If eligible, the plan administrator is required to enroll the\ndependent child in an appropriate plan, and notify the noncustodial parent's employer of the\npremium amount to be withheld from the employee's paycheck.\n  Although establishment of a medical support order is a prerequisite to enforcing the order,\ninclusion of a health insurance order does not necessarily mean that health insurance coverage is\nactually provided. According to CSE program data, in 2001, only 49% of child support orders\nincluded health insurance coverage, and the health insurance order was complied with in only 18%\nof the cases. Most policymakers agree that health care coverage for dependent children must be\navailable, accessible, affordable, and stable. Since 1977 and sporadically through 1998, Congress\nhas passed legislation to help states effectively establish and enforce medical child support. The\nNational Medical Support Notice, mandated by 1998 law and promulgated in March 2001, was\nviewed as a means to significantly improve enforcement of medical child support -- to date only\nabout half the states are using the Notice. The 1998 law also called for an advisory body to design\na medical child support incentive which would become part of the CSE performance-based incentive\npayment system -- a recommendation was made to Congress in 2001 to indefinitely delay\ndevelopment of a medical child support incentive mainly because it was argued that the appropriate\ndata was not yet available upon which to base such an incentive.\n  Improving the establishment and enforcement of medical child support has been hampered to\nsome extent by factors such as high health care costs, a decline in employer-provided health\ninsurance coverage, an increase in the share of health insurance costs borne by employees, and the\nlarge number of uninsured children. This report provides a legislative history of medical support\nprovisions in the CSE program, describes current policy with respect to medical child support,\nexamines available data, and discusses some of the issues related to medical child support. This\nreport will not be updated.",
      "type": "CRS Report",
      "typeId": "REPORTS",
      "active": false,
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          "url": "http://www.crs.gov/Reports/RL32135",
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      "topics": []
    }
  ],
  "topics": [
    "Domestic Social Policy",
    "Health Policy"
  ]
}