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The proposal implements provisions of the Child Support Performance and Incentives Act of 1998.

"This Administration is committed to exploring every opportunity to increase the number of children with health insurance," Secretary Shalala said. "For many uninsured children, private insurance is available through their parents, but it can sometimes be difficult for employers to enforce medical support orders after a separation or divorce. That's why having a simple and standard means to obtain health insurance from non-custodial parents is so important."

The proposed rule, published in today's Federal Register, provides for a uniform manner for states to inform employers about their need to enroll non-custodial parents' children in employer-sponsored health plans. The regulation also establishes a standardized National Medical Support Notice, modeled on the existing standardized income withholding form, to make it simpler and easier for employers to enforce medical support orders.

Also today, the Department of Labor issued proposed regulations that provide guidance to the administrators of group health plans in which non-custodial parents may be enrolled or eligible for enrollment. The Department of Labor guidance provides the information necessary for health plan administrators to accept the National Medical Support Notice as a "qualified medical child support order."

Medical support orders, which require non-custodial parents to include their children under their health insurance coverage, are established and enforced by state child support enforcement agencies. Currently, nearly 60 percent of the $14.3 billion a year in child support payments to 2.7 million families are collected through income withholding by employers. The new National Medical Support Notice is modeled on the standard income withholding form, which has been shown to facilitate the deduction of child support from paychecks.

"Working closely with our partners in state government, employers and the health insurance community and the Labor Department, we have developed a means to reduce some of the barriers to providing children with the health insurance they need and deserve," said Olivia A. Golden, HHS assistant secretary for children and families. "This standard nationwide notice will make it easier on employers to help parents fulfill their obligations to provide for the health and well-being of their children."

In developing the National Medical Support Notice proposal, the departments were assisted by a working group established to identify impediments to medical child support enforcement. Shalala and Labor Secretary Alexis Herman announced the formation of the National Medical Support Working Group in March. The group is studying measures that establish a non-custodial parent's responsibility to share the cost of premiums, co-payments, deductibles, or payments for service not covered under a child's existing health coverage. Other issues to be discussed include the priority of medical support withholding obligations. The group, which includes representatives of state child support and Medicaid agencies, employers, plan sponsors and administrators, will submit a report to the Secretaries in early 2000.

Since taking office, the Clinton Administration has made child support enforcement a high priority, resulting in an 80 percent increase in collections since 1992. The number of families receiving support increased by more than 59 percent during the same period, increasing to 4.5 million families in 1998. Approximately 2.8 million parents delinquent in child support payments were found last year by the National Directory of New Hires, which matches all employees, both newly hired and those already holding jobs, with a list of parents who owe child support. Paternity establishment rose to more than 1.4 million in 1998, an increase of over 300 percent since 1992. And the new child support enforcement measures included in the new welfare reform law are projected to increase collections by billions over the next 10 years.

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