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Hawaii losing
millions in fed
health funds

Forty states will lose the
needy children's insurance
money simply because
they failed to spend it

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Staff and wire services

WASHINGTON -- Forty states, including Hawaii, will soon lose hundreds of millions of dollars of federal money that was supposed to provide health insurance to children in low-income families, federal and state officials say.

The money -- 45 percent of the $4.2 billion provided by Congress -- remains unspent by the states after three years. It will be given to the 10 states that used their full allotments of federal money under the Children's Health Insurance Program, which was created by Congress with much fanfare in 1997.

"We would like to be able to keep that money and use it to provide health care to children," said Helene Robinson, director of the state program in Louisiana, which expects to lose $63.7 million, or 63 percent of its federal allotment of $101.7 million.

In Hawaii, the state estimated last year that about 5,304 children may be eligible for the program.

Sylvia Law, an expert in children's health insurance and a professor at New York University, said in November that Hawaii had pledged to enroll 440 children and spend $250,000 on the program over the next year -- far less than the state should.

"There's $9 million in Washington waiting for Hawaii to ask for it. It's outrageous," she told the Star-Bulletin.

States must provide 45 percent matching money to collect their share of the block grants, which Hawaii hadn't done at that time. State funding was to come from Hawaii's share of the tobacco settlement next year.

"I appreciate that the state is in financial crisis," Law said. "But hey, Alabama is not in such great fiscal shape. Hawaii does worse than states with greater fiscal problems."

California and Texas account for more than half the unspent money -- $590 million and $446.3 million, respectively. Together they have 29 percent of the nation's 11 million uninsured children.

Health care for children has become a major issue in the presidential campaign. Vice President Al Gore, the Democratic nominee, says that Gov. George W. Bush, the Republican candidate, has a dismal record of providing health insurance to children in Texas.

Bush rejects the criticism. Texas officials say 100,000 children have enrolled in the program since they began taking applications in April.

Dan Bartlett, a spokesman for the Bush campaign, said Gore "should address the problems on his own watch." Bartlett said the number of uninsured children nationwide had increased since the Clinton administration took office, and Census Bureau reports show the 11-million figure is up from 9.6 million in 1993.

States have until Sept. 30 to spend the money. Officials in 20 states gave these reasons for failing to use their full allotments:

Some states took a year or more to start enrolling children.

Some were reluctant to put up the state money they had to spend to obtain the full amount of federal money available.

Some states said they could not find enough eligible uninsured children to use all their federal money.

Some states inadvertently deterred enrollment by using complex application forms and procedures.