Governor Ron DeSantis is suing to impose new federal guidelines requiring that children maintain their state-subsidized health care insurance even if their parents drop premium payments.
If parents don’t pay premiums and children are allowed to remain on state-subsidized insurance, as the feds require, the new rules would be costly, the state argues. According to the 411-page complaint filed in federal court by the state on Thursday, the estimate is about $30 million in unpaid premiums under the current system and would rise to nearly $50 million under the state’s expansion of Florida KidCare, approved last year. It is possible
Florida is the first state to file a lawsuit, according to critics. It’s another chapter in the contentious relationship between the DeSantis administration and the Fed.
“The Biden administration seeks to unlawfully weaken that requirement (for premium payments) and turn the program into a free-for-all program, threatening both its solvency and long-term sustainability,” the complaint states. “Those actions threaten the program’s expansion to Florida’s neediest children.”
Critics said the state led the nation in kicking children out of Medicaid, the state insurance for the poor, at the conclusion of the pandemic. Joan Elker, executive director of the Georgetown University Center for Children and Families, said Florida was topped only by Texas because more than 400,000 Florida children were set to lose their health insurance as part of Medicaid after the 2023 closing.
In December, Florida was one of nine states that received a letter from Department of Health and Human Services Secretary Xavier Becerra warning about the number of people losing health insurance due to procedural issues.
And this is a continuation of the same pattern, Alkar said.
“The Governor of Florida has filed a lawsuit asking a judge to give him special permission to cut off Children’s (state health insurance for children) coverage for non-payment of certain premiums and non-compliance with federal law, which was created to protect families from medical debt and ensure that children have access to the health care they need,” Alker said in a prepared statement. “If he is successful, the Governor will ensure that Florida “More children in the U.S. will spend more time uninsured. This is harmful and jeopardizes children’s health and educational outcomes in the short and long term.”
Currently, 119,000 children are covered by KidCare, which is made up of several government-subsidized health care plans, including Healthy Kids, the complaint said. Supported by both state and federal funding, KidCare requires a small, monthly premium from recipient families and covers children ages 5 to 18.
Legislation passed unanimously in 2023 (HB 121) raised the eligibility threshold to include those earning up to 300% of the federal poverty level (FPL), which is $93,000 for a family of four, up from 200%. Above the maximum household income. FPL.
The expansion could put 26,000 more children on state-subsidized insurance.
But disagreements are blocking an extension that should have taken effect immediately. This is because the federal government has mandated that expanded eligibility cannot be implemented with a simple plan amendment. Instead, the Fed demanded the state apply for a waiver, sparking a conflict.
The Centers for Medicare & Medicaid Services (CMS) have indicated they will not approve Florida’s proposed expansion without amending the provisions that would have barred the state from paying premiums if premiums were not paid during the continuous eligibility period, the complaint said. Permits the cancellation of the enrollment of an eligible child.
The complaint says CMS’s rule means “there will be no consequences for failure to pay a premium, thereby severely reducing participants’ incentive to make any premiums after the first month (of enrollment).” ” As a result, widespread non-payment is a reasonable expectation.”
Holly Bullard, chief strategy and development officer at the Florida Policy Institute, lamented that the Sunshine State is the first state to pursue this lawsuit against the federal government’s rule and fears the impact it could have on child health insurance across the country.
“This was a victory for the legislature and the children, and I hate to see that a lawsuit between the state and the federal government will result in even further delays in care for thousands of children,” he said.