The Report

Letter of Announcement to the President of the Senate

Letter of Announcement to the President of the Senate

Letter of Announcement to the Speaker of the House of Representatives

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Executive Summary

Chapter 1, Lack of Health Care Coverage

Chapter 2, Partnership for a New Medical Child Support Paradigm

Chapter 3, Taking the First Step: Establishing Health Care Coverage in Child Support Orders

Chapter 4, Implementing a New Tool: The National Medical Support Notice and Related Issues

Chapter 5, Answering Hard Questions: Providing Guidance to IV-D Agencies and Employers on Enforcement Issues

Chapter 6, Moving Towards Seamless Coverage: Improving Coordination and Communication Among Private and Public Health Care Coverage

Chapter 7, The Question of Money: Paying for the Expanded Role of the IV-D Program in Obtaining Health Care Coverage for Children

Chapter 8, Shaping the Future: Strategies for Ensuring Ongoing Improvements

Chapter 9, Conclusion/Postscript

Appendices

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Executive Summary
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Full Report
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The Honorable Albert Gore, Jr.
President of the Senate
Washington, DC 20510

Dear Mr. President:

This letter transmits a copy of the Medical Child Support Working Group's Report, "Twenty-One Million Children's Health: Our Shared Responsibility." The Medical Child Support Working Group is an independent body established under the Child Support Performance and Incentive Act of 1998 to develop recommendations for effective enforcement of medical support orders by

State child support enforcement agencies and to report those recommendations to the Secretaries of Health and Human Services and Labor.

The Working Group's report contains 76 recommendations for improving medical support order enforcement and access to health care coverage for children eligible to receive child support enforcement services. The Administration is presently reviewing the Working Group's recommendations.

We look forward to working with Congress in examining these recommendations, and moving forward to help more children have access to the health care coverage they need and deserve. An identical letter has been sent to the Speaker of the House of Representatives.

Sincerely,

Donna E. Shalala
Secretary of Health and Human Services

Alexis M. Herman
Secretary of Labor