Gov. Rick Scott likes to talk about eliminating government rules for businesses, but when it comes to helping Florida's poorest children enroll in government-funded health insurance, he doesn't mind the red tape. This sentiment recently cost Florida millions of dollars in federal bonus money awarded to those states that improved access to low-income children's health programs. Scott and the Republican-controlled Legislature appear to have no interest in reducing the bureaucratic hurdles for the families who qualify, which means Florida will continue leaving federal money on the table and leaving poor children uninsured and out of luck.
It wouldn't have taken much for Florida to earn a piece of the $300 million in federal performance bonuses. After all, Alabama received $19 million, Georgia got almost $5 million and Louisiana nearly $2 million, and these are not states known for liberal social welfare policies. All Florida needed to do was to meet five of eight measures designed to ease the path for low-income families to enroll and remain in Medicaid, a government health program for the state's poorest children, and KidCare, a subsidized health insurance program for children whose families earn up to 200 percent of the federal poverty line.
The eight measures are commonsense adjustments such as letting enrollees remain covered for 12 continuous months even if a family's finances seesaw up and down, so as not to interrupt care; and "presumptive eligibility," which allows children to be covered as soon as their parents apply without waiting for a premium payment.
But a bill in 2010 sponsored by Democratic state Sen. Nan Rich of Weston that would have made these changes did not interest Scott or legislative leaders and there is no indication that this session will be different. The reason is simple: The fewer children enrolled in government-funded health care programs, the less the state spends to care for them — a calculation as shortsighted as it is mean. KidCare has enrolled 20,000 fewer children than budgeted for, which may save the state money on the front end, but Florida also loses $22 million in corresponding federal funds.
The longer-term consequence, however, is likely more costly: Thousands of low-income children without health insurance won't get the preventive care they need and will likely be forced into expensive emergency rooms for even routine care, the cost of which the entire health care system often has to absorb.
Florida has 380,000 children who are uninsured but whose parents' income qualifies them for coverage — the third-highest number in the nation. If the state's leaders were at all interested in getting these children enrolled, they would adopt "express lane eligibility," like Georgia and South Carolina. This allows the state to use eligibility for other public programs, such as food stamps or free or reduced school lunches as a means of finding and signing up children for Medicaid or KidCare. Low-income parents are relieved of repetitive and burdensome paperwork — less government bureaucracy — and "express lane eligibility" is one of the eight criteria that would help qualify the state for a performance bonus.
But nothing like that is planned for Florida, which still requires parents to fill out separate applications for Medicaid and KidCare. For Scott and the Legislature, better that the state relinquish millions in federal bonus funds than make it easier for poor families to get state-supported health coverage for their children.