The Honorable J. Dennis Hastert
Speaker of the House of
Representatives
Washington, DC 20515

Dear Mr. Speaker:

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 President of the Senate.

Sincerely,

Donna E. Shalala
Secretary of Health and Human Services

Alexis M. Herman
Secretary of Labor