To the Editor Hauptman et al1 found that children with public insurance have greater odds of detectable and elevated blood lead levels (BLLs) than children with private insurance. A recently released report from the US Department of Health and Human Services Office of Inspector General (OIG) report2 reviewing blood lead screening tests in 5 large states for federal fiscal years 2015 to 2018 found that 38% of 1.8 million Medicaid-enrolled children did not receive a blood lead screening test at ages 12 and 24 months as Medicaid requires. Thus, the number of children with public insurance that have detectable and elevated BLLs may be even higher and the disparities even more stark than noted in Hauptman et al.1