Millions of low-income children are failing to get the free preventive exams and screenings guaranteed by Medicaid, and the Obama administration is not doing enough to fix the problem, according to a federal watchdog report.

The report, released Thursday by the Department of Health and Human Services’ Office of Inspector General (OIG), says the administration has boosted rates of participation but needs to do more to ensure that children get the regular wellness exams, dental checkups, and vision and hearing tests.

The report notes that 63% of children on Medicaid received at least one medical screening in 2013, up from 56% in 2006, but still far below the department’s 80% goal.

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