More than 22K children dropped from Florida KidCare in 2024 as state challenges federal eligibility protections

In a move that some have called “egregious,” Florida since January has dropped more than 22,000 children from a subsidized health insurance program for failing to pay premiums despite the federal government saying it cannot.

State data shows that 6,780 children were disenrolled from the Florida Kidcare program on Jan. 1, which, according to the federal government, is when a 12-month eligibility requirement went into effect for children enrolled in the Medicaid or the state children’s health insurance program (CHIP), which in Florida is called Florida KidCare.

That was followed by another 5,147 children in February, 5,097 children in March, and another 5,552 in April.

“Florida, as it stands is the only state who is challenging this new protection and Florida is the only state that we know of that is violating the new protection as we speak,” said Joan Alker,  executive director of the Center for Children and Families and a Research Professor at the Georgetown McCourt School of Public Policy. “ This is a brazen disregard for federal law that is designed to protect children from becoming uninsured. It’s discouraging to see this and Florida clearly is doubling down.”

The 12-month continuous eligibility requirement was included in the 2023 federal budget. The Biden Administration flagged the change in a September 2023 State Health Official letter that was sent nationwide and an October 2023 “Frequently Asked Questions” follow-up document further explaining the policy change and enforcement.

The DeSantis administration three months later, however, filed suit in federal court asking a judge to block the Centers for Medicare and Medicaid Services (CMS) from enforcing the 12-month continuous eligibility requirement and taking action against states that don’t abide by the mandate.

The preliminary injunction request, which is being heard in Tampa federal court on Thursday morning, contends that CMS exceeded its authority and that Congress did not require continuous enrollment. The motion, which was drawn up by Attorney General Ashley Moody and lawyers from the Boyden Gray law firm, also says that the premium payment requirement is part of Florida law and that it is needed to help maintain the solvency of the program. The Florida Legislature last year expanded which families could qualify for the program.

“The state legislature established Florida CHIP as a personal-responsibility program, not an entitlement, and Florida has a sovereign interest in carrying out that decision,“ states Florida’s motion.

“Really, I’m shocked,” said Florida Health Justice Project attorney Lynn Hearn, who obtained the disenrollment data from the Florida Healthy Kids (FHK) Corporation, which administers the Florida KidCare program.  “It seems like Florida is acting as if it has already won its lawsuit. They don’t believe they should be prohibited from disenrolling children for non-payment of premiums so regardless of what the (the federal government) says, they are proceeding with the disenrollment, while at the same time asking the judge for permission.”

 FHK spokesperson Ashley Carr told Florida Politics Wednesday night that the organization does not comment on pending litigation.

Florida KidCare is an optional Medicaid expansion program for children aged 5-18 whose families earn too much to qualify for the traditional Medicaid program. Congress set up the program in 1997 and agreed to pay states roughly 15 percentage points more than the traditional Medicaid match rate. The Florida Legislature agreed to pass the optional Medicaid expansion a year later, and the federal government pays about 69 cents of every dollar spent on the program.

Unlike traditional Medicaid, which is free for enrollees, state law requires Florida KidCare enrollees to pay a small monthly premium.

The DeSantis administration argues that the continuous eligibility requirement runs amok of state law.

While Florida is the only state to challenge the 12-month eligibility requirement, Alker said the challenge, if successful, would preclude the federal government from enforcing the eligibility requirement nationally.

A CMS spokesperson said the agency does not comment on litigation.