Overlooked amid the feel-good rhetoric about a new federal law expanding health care coverage to 11 million more children was this: Florida has failed for years to fully enroll its KidCare program, leaving millions of federal dollars on the table and thousands of qualified children uninsured.
That needs to change in Tallahassee. Gov. Charlie Crist and Republican legislative leaders need to find the dollars to capitalize on the expansion of the State Children's Health Insurance Program, and they must revamp a bureaucratic enrollment process. To continue to fail to meet KidCare's full potential is a horrible disservice to Florida's 797,000 uninsured children and their parents.
Low-income families pay between $15 and $20 a month per child to enroll in KidCare, a subsidized health insurance program. To qualify, families must earn no more than 200 percent of the poverty level — or $44,100 for a family of four. Government picks up the rest of the cost. For every $29 the state spends, the federal government sends down $71 that gets spent with Florida doctors, laboratories and hospitals.
But the woes of Florida's KidCare program go back to 2004 when Gov. Jeb Bush and the Republican-led Legislature opted not to spend the dollars needed to address a 90,000-child waiting list. Instead, the Legislature made the application process more onerous and instituted twice-a-year enrollment periods. The result was devastating. Enrollment dropped from a high of 335,000 to 208,000 in a year.
The following year lawmakers restored year-round enrollment but maintained many of the enrollment barriers, such as a six-month wait for coverage in some cases, a cumbersome renewal process and a lackluster marketing effort. Other families were stymied by glitches blamed on third-party administrators. As a result, enrollment has never rebounded even as the state's uninsured ranks have risen and insurance prices have skyrocketed. Just 240,000 children are enrolled in KidCare — which is 51,000 less than the state has budgeted.
There's no excuse for that. For years, advocates from both parties have tried to address the bureaucratic problem in the Legislature but gotten nowhere. This year, state Sen. Nan Rich, D-Sunrise, is leading the effort. Republican leaders should take a serious look at her plan. But they should also fully embrace the spirit of the congressional expansion of SCHIP, which would allow states to offer the program to more families by raising the qualification threshold to 300 percent of the poverty level — or $66,150 for a family of four.
It won't be cheap, particularly in this economy and as the state faces a $3.5 billion shortfall next year. Two Democrats, Chief Financial Officer Alex Sink and U.S. Rep. Kathy Castor of Tampa, are hoping that the eventual federal stimulus package that emerges in Washington will help Florida pay its share of the SCHIP bill. Regardless, Florida's Republican leaders — including U.S. Sen. Mel Martinez, who voted for the SCHIP expansion — need to join the push in Tallahassee to ensure that more children actually benefit. It would be a valuable lifeline not only to struggling families but also to the state's health care economy.