The Bush administration uses a different approach than most public health researchers do when it calculates the number of U.S. children without health coverage.
Peter Orszag, director of the Congressional Budget Office, presented that argument today in a letter to Sen. Max Baucus, D-Mont.
Baucus, chairman of the Senate Finance Committee, previously had asked the CBO to explain why the Bush administration says only 1.1 million U.S. children lack health coverage and are eligible either for Medicaid or for the State Children's Health Insurance Program.
Earlier, "empirical" studies have suggested that about 5 million to 6 million children who are eligible for public health insurance programs are uninsured, Orszag writes.
A "major reason that the administration's figure is much lower than other estimates is that they address different questions," Orszag writes.
"In particular, the administration's estimate addresses how many children are uninsured for an entire year and are eligible for Medicaid or SCHIP," Orszag writes.
The administration estimate leaves out many children who are uninsured for part of the year and are eligible for public coverage during that period, Orszag writes.
"Consequently, the administration's estimate understates the number of uninsured children who might participate in Medicaid or SCHIP under policies aimed at expanding enrollment," Orszag writes.
The other estimates from the research literature are instead based on the number of children who are uninsured and eligible for Medicaid or SCHIP at a particular point in time, Orszag writes.