Bush Administration Considers Ending Requirement that States Test Medicaid Beneficiaries for Lead Poisoning

The Bush administration is considering a proposal that would eliminate the requirement that states test all young children in Medicaid for elevated lead levels, USA Today reports. The new plan would grant states the authority to determine which children should be screened. Under current federal law, all states are required to test children on Medicaid at age 12 months and again at 24 months for elevated lead levels. The proposed policy shift was prompted by complaints from some states, including Alaska and Utah, that they should be exempt from universal testing because they have relatively low lead concentrations. The federal Advisory Committee on Childhood Lead Poisoning Prevention began revising the screening requirements during the Clinton administration but has yet to make formal recommendations. The committee was informed last month that Medicaid officials are working on the policy change separately. The CDC suggests that states continue testing to determine where children are not at risk and then eliminate those areas from mandatory testing. The White House is contemplating allowing states to drop areas "without first proving they are lead-free," USA Today reports. Bush administration officials said that the policy shift is an attempt to make lead screening "more efficient." A CMS spokesperson said the proposal is "in its early stages," and the administration is considering other options.

Testing Already 'Lax'
Some health officials, however, express concern that relaxing the screening requirements could be detrimental to a population already at risk. They cite government statistics that show that "most states are lax" at lead poisoning testing. Of the 890,000 children with elevated lead levels, 535,000 are on Medicaid, according to a 1998 GAO report. In addition, federal officials say that only 10% of poor children were tested in 1999 and 2000. "If we move to a more hands-off approach, the future for Medicaid children who are lead-poisoned is going to get worse," Amy Murphy, a member of the federal advisory committee from the Milwaukee Health Department, said (Parker, USA Today, 4/17)