State sues feds over rule that keeps kids on state-subsidized health care even if parents skip premiums

The disagreement has kept potentially 26,000 kids from getting state-subsidized health insurance.

Gov. Ron DeSantis is suing to toss new federal guidelines that require kids to keep their state-subsidized health care insurance even if their parents skip premium payments.

If parents don’t pay premiums and kids are allowed to stay on the state-subsidized insurance, as the feds are requiring, the new rules would be costly, the state contends. Estimates are that it could add up to nearly $30 million in unpaid premiums under the current system and nearly $50 million under the state’s expansion of Florida KidCare approved last year, according to a 411-page complaint the state filed in federal court.

Florida is the first state to file suit. According to critics, it’s another chapter in the contentious relationship between the DeSantis administration and the feds.

“The (Joe) Biden Administration unlawfully seeks to undermine that requirement (for premium payments) and turn the program into a free-for-all, threatening both its solvency and long-term stability,” the complaint reads. “Those actions threaten Florida’s expansion of the program to more children in need.”

Critics have noted the state led the nation in booting kids off Medicaid, the state’s insurance for the poor, at the conclusion of the pandemic. Florida was topped only by Texas, as more than 400,000 Florida children lost their health insurance as part of the Medicaid unwinding as 2023 wound down, noted Joan Alker, Executive Director of the Georgetown University Center for Children and Families.

In December, Florida was one of nine states that received a letter from Department of Health and Human Services Secretary Xavier Becerra raising the alarm about the number of people losing health insurance because of procedural issues.

And this is a continuation of the same pattern, Alker said.

“The Governor of Florida has filed suit asking a judge to give him special permission to kick children off (state health insurance for children) coverage for nonpayment of certain premiums and not comply with the federal law — which was designed to protect families from medical debt and ensure children have access to the health care they need,” Alker said in a prepared statement.

“If he is successful, the Governor will ensure that more children in Florida will spend more time being uninsured. This is harmful and puts children’s health and educational outcomes at risk in both the short and the 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 says. KidCare, supported by both state and federal money, requires a small, monthly premium from recipient families and covers children, ages 5 to 18.

Legislation (HB 121) that passed unanimously in 2023 increased 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 the maximum household income of 200% of the FPL.

The expansion could put 26,000 more children on the state-subsidized insurance.

But the disagreement is holding up that expansion that was supposed to go into effect immediately. That’s because the federal government decreed that the expanded eligibility couldn’t take hold with a simple plan amendment. Instead, the feds required the state to apply for a waiver, triggering the showdown.

Centers for Medicare & Medicaid Services (CMS) “indicated it would not approve Florida’s proposed expansion without accompanying modifications to … provisions that allow the state to disenroll an eligible child for nonpayment of premiums during the continuous eligibility period,” the complaint reads.

The CMS rule, the complaint says, means “there is no consequence for failing to pay premiums, severely diminishing the incentive of participants to make any premiums after the first month (of enrollment). As a result, widespread nonpayment is a reasonable expectation.”

Holly Bullard, chief strategy and development officer for the Florida Policy Institute, lamented that the Sunshine State is the first to pursue this litigation against the federal government’s rule and feared the effect it could have on child health insurance across the country.

“This was a win for the Legislature and the kids and I hate to see a lawsuit between the state and the federal government delay even more access to care for tens of thousands of kids,” she said.

Anne Geggis

Anne Geggis is a South Florida journalist who began her career in Vermont and has worked at the Sun-Sentinel, the Daytona Beach News-Journal and the Gainesville Sun covering government issues, health and education. She was a member of the Sun-Sentinel team that won the 2019 Pulitzer Prize for coverage of the Parkland high school shooting. You can reach her on Twitter @AnneBoca or by emailing [email protected].


  • Earl Pitts "Sage Political Expert Emeritas" Ameriecan

    February 4, 2024 at 7:48 pm

    Good evening America,
    Once again Ron Desantis leads the other 49 States in common sense by filing this law suit.
    The Dook 4 Brains Democrat in charge ( how y doing 8arak 0bama ) thinks [in 8arak’s Dook filled brain] that just because Calafornia is Bankrupting their state with Free Health Care for All that all States just needed a Federal Guideline nudge to also bankrupt their States too ….. NOT GONNA HAPPEN ON THE SAGE RON AND THE BEAUTIFUL CASEY’S WATCH!
    Thank God for Ron DeSantis.
    And thank you beloved Citizens of America,
    Earl Pitts American
    *Queue Extreamly LOUD Patriotic Music to Whizz Off All of the Dook 4 Brains Leftist Readers*

    • Ruth Diehl

      February 5, 2024 at 9:00 am

      Seriously you are saying that this plan is an answer to saving money versus saving lives? It is a sin what is going on in our state. If a person has not been able to pay possibly they can’t afford it maybe lost their job which is quietly happening all over this state? Such a disheartening affair, your laws force people to have children when they don’t want them or can’t afford them; and then your laws refuse to help them keep their children safe and healthy. A small amount times four can be difference between lights on , food on the table or a roof over their heads. I get that this I a foreign concept to the many that have, but to those that do not, it could be the difference between life and death.

    • George

      February 5, 2024 at 9:50 am

      Earl, you’re a true patriot. You believe in an America where everyone is equal, a long as you can pay.

  • Lynda

    February 4, 2024 at 8:28 pm

    Leave it to a MAGA troll to name call everyone who understands
    the health of all of the children in the USA is important to the future of our country. All Americans should work to protect the health of all of our children. deSantis, of course is one of the worst governors in the USA when programs which protect the health of children are available. He and some of those (never missed a meal) governors who lick his “boots” refused to accept Federal Food for children who are hungry during the days when their school does not provide breakfast and lunch at no cost to the state taxpayers. Shame on deSantis and the “beautiful” Casey for their lack of compassion for children other than theirs.
    Shame on them for their purposeful cruelty and failure to protect Florida’s children from disease and hunger no matter who their parents are or what those parents fail to do.

    These actions are why I will never believe in the MAGA Republican advocacy for a so-called Pro-Life position. Everyday when these hypocrites shout their love for the “unborn” I hear their hatred for children already breathing and the women forced by the Legislature’s ignorance to give birth and risk their lives because some old men are too stupid to learn about the risks of pregnancy for women. Wait until you MAGAites in the cult of trump face the angry women voters of the USA in the 2024 election. So laugh now and call us who care about all children whatever your busy little brains can come up with. You will be crying in November when your (hero, saviour, g-d) trump loses like he always does.

    • Earl Pitts "Sage Political Expert Emeritas" Ameriecan

      February 5, 2024 at 2:02 am

      Thank you beloved Lynda for reaching out for my Fatherly disipline which you crave.
      You are heteby Chastized for your nonsencical use of lies, damn lies, and statistics to try to lamely attempt to cast shade on my, excellant posting of educational and sage wisdom. Plus you used too many words in your leftist rant. Your painfull chastizement will last an entire week unless I see some improvement in your behaviour by being nice and respectfull to me, Earl Pitts American.
      Thank you Lynda for your understanding,
      Earl Pitts American

    • Ruth Diehl

      February 5, 2024 at 9:03 am

      Exactly there is no time to sleep all caring persons must be fully awake.

  • Giles

    February 5, 2024 at 6:20 am

    Earl Pitts your an idiot, but so be it. If DeSantis really cared about Florida and the people he would get a brain. Maybe do the job that idiots voted him in to do. Instead how many thousands of dollars did he waste of tax payers dollars to run around and pretend he could be the next president, how many hours did we pay him to be governor that he was absent for. How many plane trips did we Floridians pay. I bet we paid millions more than the amount of taking care of our children. MAGA idiots need to wake up. Women are now forced to have babies, men are not forced to pay child support. Those babies with issues then become the women’s problem, and she ask for help and in Florida, there is no help, no child care, no food stamps, no medical. You tell me what is the single mother suppose to do, when her child is born with needing a ventilator, a g tube, and multiple other medical issues. Where is she going to get the 24 hours a day care the child needs, then these idiot MAGAs tell her to get a job and pay your premiums. Florida has a 25 year back log on title 10 Medicaid, meaning if you child has a severe medical condition, and you are not allowed to abort, than you will get no help with long term care, you yourself as a single mother will need to stay home and care for that child with no help from the state. I will never vote for anyone who takes my right away, unless there is a new law that says, all men are castrated by law, no excuse when they turn 18. Along with a law that says, all men who got a women pregnant has to pay from day one of pregnancy $1000 a month, every month for 21 years of that child’s life. Than we could stop some of these programs like food stamps, and average medical and focus only on the severe medically needy.

  • Earl Pitts "Sage Political Expert Emeritas" Ameriecan

    February 5, 2024 at 5:48 pm

    Giles is also chastized by me, The Sage Earl Pitts American, for engageing in non-senseical Dook 4 Brains Leftist rambeling.
    Be ashamed Giles be very ashamed.
    Thank you Giles,
    Earl Pitts American

    • JD

      February 5, 2024 at 9:46 pm

      Arm Pitt Shitts, do the world a favor and go die.

Comments are closed.


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