Florida Faces Controversy Over Children’s Healthcare Coverage amid the End of Pandemic-Era Protections

MIAMI, FL – As pandemic-era protections for Medicaid participants come to an end, millions of low-income Americans are losing their coverage. This unsettling trend has raised concerns about the fate of children who rely on the program. The Department of Health and Human Services recently sent letters to nine states, including Florida, urging them to do more to keep children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP).

Florida has been at the center of this issue, having already removed 420,000 children from both Medicaid and CHIP. Chip insures children from families with modest income who do not qualify for Medicaid. In response, Florida is challenging a federal law that now requires states to provide 12 months of continuous Medicaid or CHIP eligibility for children. However, Florida has also taken steps to expand CHIP eligibility by increasing the income limit for qualifying families.

The state’s approach has brought the overall state of children’s health insurance coverage in Florida into question. Florida currently has a children’s health insurance program like most other states, with approximately 120,000 children enrolled from low and moderate-income families. However, Florida is contesting the federal government’s authority to change the rules regarding enrollment in the program. Specifically, Florida argues that it should be allowed to dis-enroll children whose parents do not pay premiums, despite the new federal requirement of 12 months of continuous eligibility.

While Florida is the only state challenging the new federal rule, 18 other states currently disenroll children from CHIP if their parents fail to pay monthly premiums. These states will need to decide whether to comply with the new federal rules or join Florida in its lawsuit.

The Biden administration has responded to Florida’s lawsuit, arguing that the Consolidated Appropriations Act of 2023 made continuous eligibility mandatory for both Medicaid and CHIP. The administration maintains that the same protection against dis-enrollment for nonpayment should apply to children in CHIP as well.

In addition to Florida’s CHIP situation, the state has also faced criticism for the high proportion of children being disenrolled from Medicaid. As of January, nearly 460,000 children had been disenrolled from Florida’s Medicaid program. This has prompted the Department of Health and Human Services to express concern and suggest strategies to help states maintain coverage for their children. Medicaid expansion is one such strategy, as it improves coverage for children when their parents have health insurance.

Although Florida recently voted to raise the income limit for qualifying families under the Children’s Health Insurance Program, the expansion has not yet taken effect. While an estimated 40,000 additional children would be newly eligible, the state still needs to complete a complex process involving state and federal public comment periods.

Florida’s approach of expanding income eligibility while maintaining premiums has raised questions. The state argues that these premiums help fund the CHIP program, and they rely on them to cover the costs of the expanded population. However, the Centers for Medicare and Medicaid Services (CMS) aims to reduce interruptions and churn in coverage by implementing new rules for continuous eligibility and coverage.

The future of children’s health insurance coverage in Florida remains uncertain as the state’s legal battle with the federal government continues. The outcome of the lawsuit and the decisions made by other states will determine the fate of millions of low-income children across the country.

Thank you to Daniel Chang, a correspondent for KFF Health News based in Florida, for providing insights into this important issue.