Rich: 'Dallying' Costing KidCare Millions

By: Margie Menzel, The News Service of Florida
By: Margie Menzel, The News Service of Florida

THE CAPITAL, TALLAHASSEE, Jan. 5, 2011 --

Florida’s failure to qualify for new money to enroll more children in the state’s subsidized children’s health insurance program is due to legislative inaction, said Senate Democratic leader Nan Rich.

Last week the Obama Administration awarded $206 million to 15 states for signing up children who are eligible for public health insurance but not enrolled. The bonus money, intended to encourage states to enroll more uninsured children, was set aside when Congress reauthorized the Children’s Health Insurance Program (CHIP) last year.

But Florida is barred from competing for the money because it hasn’t implemented some program changes needed to qualify.

“It galls me to see Florida losing this money,” Rich said late last week. “Failing to make our state eligible for this grant program not only leaves thousands of children at risk, it leaves our taxpayers footing another high dollar bill for frantic trips to the emergency rooms.”

Florida is ranked 49th of the 50 states in insuring children’s health, according to both the Urban Institute and the Kids Count survey by the Annie E. Casey Foundation; approximately 700,000 of the state’s children lack coverage. While the Urban Institute Health Policy Center’s American Community Survey finds that 10 percent of U.S. children lack coverage, it shows Florida with 16.7 percent uninsured.

Florida meets only two of the eight benchmarks set by Congress, said Rich Robleto, executive director of the Florida Healthy Kids Corporation, the KidCare partner that provides the administrative services for CHIP. But states must meet five of the eight to qualify for the bonus money.

During the 2010 legislative session, Rich sponsored legislation (SB 2082), which, if passed, would have met two more of the benchmarks: continuous eligibility and presumptive eligibility.

The former refers to an eligibility requirement of a full twelve months for all children. In Florida, school-age children in Medicaid are eligible for KidCare in six-month increments before having to renew their applications.

That’s a barrier to enrollment, said children’s advocate Karen Woodall, a member of the KidCare Coordinating Council.

“A lot of parents don’t realize – because it’s not logical and it doesn’t make sense – that the … child has to be renewed,” she said. “So they don’t comply and the kid loses coverage.”

The bill also would have taken care of the presumptive coverage issue: creating the default situation that children are eligible for KidCare until proven otherwise. But Sen. Don Gaetz, R-Niceville, who was chairman of the Senate Health Regulation Committee, where the bill died, said the state couldn't’t afford it.

“There would have been a state outlay at a time when the taxpayers and families of Florida did not want to raise taxes,” Gaetz said.

Florida pays 29 cents on the dollar for Kidcare enrollees, while the federal government picks up the remaining 71-cent cost.

Woodall acknowledged that the cost is problematic for states having trouble balancing their budgets. That’s why, she said, Congress established the bonus payments.

“It’s really a philosophical viewpoint,” she said. “If your mindset is that you’re going to identify and enroll uninsured children, then you should be looking to remove any barrier that exists to keep them out…If you look, particularly across the South, there are a number of barriers that have been created to limit enrollment.

“Alabama used to have them, and that’s why they got $55 million in bonus money – because they removed the barriers,” said Woodall.

With the passage of Rich’s bill and some administrative changes that Healthy Kids is now implementing, Robleto said, Florida would qualify.

Gaetz is zeroing in on another barrier by co-sponsoring a bill this session with Sen. Eleanor Sobel, D-Hollywood. The two are proposing to make applying for the Free and Reduced Lunch Program tantamount to applying for KidCare.

“I think Sen. Sobel’s and my bill will streamline the enrollment process,” Gaetz said.

But Rich said that alone would still leave Florida ineligible for the federal payments. She said a slim chance remains that Florida could qualify for bonus payments through 2013 if the Legislature moves quickly to meet the federal guidelines.


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