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.

The Senate has been trying to increase the budget of SCHIP to an average of $12 billion per year over the next 5 years, up from $5 billion today, and the House wants to increase SCHIP spending to an average of $15 billion per year.

The Senate Finance Committee approved a bill that would pay for an increase in SCHIP spending by increasing tobacco taxes, and some House members have talked about shifting some Medicare Advantage funding to SCHIP.

The Bush administration wants to increase SCHIP spending to about $6 billion per year and end some states’ efforts to use SCHIP money to cover childless adults and children from homes with relatively high incomes. The Bush administration also wants to cap the group health insurance premium deduction and use the savings to offer the same deduction to individuals who buy their own health coverage.

In relates news:

- America’s Health Insurance Plans, Washington, is preparing for House efforts to cut Medicare Advantage payments by launching a national television advertising campaign that will encourage concerned citizens to urge their member of Congress to protect seniors’ Medicare Advantage benefits. The ads will run nationally and in key markets across the country.

- Rep. Artur Davis, D-Ala., a member of the House Ways and Means Committee, has issued a statement attacking efforts to keep Congress from shifting Medicare Advantage funding into SCHIP.

“Front groups for the nation’s private insurance industry have launched an assault on committee members who are working to ensure that the future health care needs of our children and our seniors are met,” according to the introduction to the Davis statement.

“The reduction in the Medicare Advantage program will in no way disturb the underlying Medicare program itself,” Davis says. “The only losers will be an industry that will have to forfeit some of the windfall profits it has enjoyed under the Bush administration.”