New rules for children’s health insurance intensify the federal authorities’ legal dispute with Florida

New federal rules designed to ensure that children from low-income families taken off Medicaid don’t lose health coverage could heighten tensions between the Biden and DeSantis administrations.

The Department of Health and Human Services announced Wednesday that it has finalized regulations that make it easier for children to enroll and stay enrolled in federally subsidized health insurance programs, including Medicaid and the Florida Children’s Health Insurance Program, known as KidCare.

Under the new rules, children who become uninsured should be able to switch to KidCare immediately instead of the up to 60-day delay that can occur in Florida. The new policy also ends lifetime limits on how much Children’s Health Insurance programs spend on individual children and guarantees at least 12 months of continuous coverage, limiting states to no more than one eligibility check per year.

The move comes after more than 560,000 children in Florida have been taken off Medicaid since last April, when Florida undertook the first review of approximately 5 million Medicaid recipients since the end of the public health emergency COVID-19. A state plan to deal with the transition states that eligible children will be covered by KidCare, but enrollment in the program has increased by only about 55,000 during the same period.

Florida is the only state that has not taken advantage of more than a dozen waivers and options for states to ensure that children do not lose health insurance during this period.

“The fact that so many children and families are losing their health coverage in Florida is not just troubling; it’s a tragedy for these families — especially if their children qualify to receive the services, it’s unconscionable,” Health and Human Services Secretary Xavier Becerra said in an interview with the Tampa Bay Times. “We will do everything we can to ensure that children are not dragged into this bureaucratic nightmare.”

Florida officials disputed Becerra’s characterization of the state’s handling of Medicaid, saying their approach ensures that aid reaches those who “really need it, especially since Florida’s booming economy may make some families ineligible for aid’.

“Attempting to shift the blame to states for federal regulations is both irresponsible and dishonest,” Florida Department of Children and Families spokeswoman Mallory McManus said in an email. “Instead of always pushing for government expansion, we encourage the federal government to adopt our successful approach to Medicaid redefinition.”

McManus also pointed to the Florida Legislature’s 2023 bill to expand KidCare to more low-income families as an example of the state’s commitment to families.

But that expansion is in doubt because of a dispute over a provision in the new rules that prevents states from ending coverage for children whose parents don’t pay monthly premiums.

Florida’s health agency last month filed a lawsuit in federal court in Tampa, claiming the federal government was overstepping its authority. in passing the provision. A hearing on the ongoing dispute is scheduled for April 18.

The expansion would raise the family income limit for children to qualify for the program from 200 percent to 300 percent of the federal poverty level. It is estimated to provide health insurance for an additional 42,000 children in Florida, according to an analysis of the bill.

The federal Children’s Health Insurance Program will cover about 72 percent of the cost, roughly $25 million a year, with the state picking up the balance, estimated at about $10 million.

Monthly premiums for KidCare are $15 or $20 depending on household income, but most families pay nothing, according to KidCare’s website.

Child health advocates said the new federal rules will help low-income families ensure their children can still get medical care. Waiting periods for children’s health insurance programs are “outdated red tape barriers” to medical care for children, said Joan Alker, executive director at Georgetown University’s Center for Children and Families.

“It’s high time we got rid of these policies that put additional burdens on families,” she said.

Florida is now in the final month of the redetermination process, a period during which it plans to evaluate the eligibility of children with complex medical needs.

Officials with the Florida Health Justice Project, a nonprofit that advocates for greater access to health care, said they’ve seen a recent uptick in calls from panicked parents who have been told by their child’s health care provider that their Medicaid coverage will expire in early April.

“Parents need to know now what their options are and how they can best keep their children covered,” said Miriam Hartmatz, the nonprofit’s director of advocacy.