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Fight looms over kids' health care

Gov. Jeb Bush boasts about providing health insurance to a quarter-million poor children since 1999, but his success is clouded by a new political liability: 100,000 kids stuck on waiting lists.

Florida's Healthy Kids program, a 14-year-old prototype for a federal program copied in all other states, has steadily grown in popularity. With premiums beginning at $15 a month, it is an inexpensive option for low-income families who cannot afford private medical coverage.

For the past six years, most of the cost has been paid by the federal government.

But when Bush unveiled a proposed 2004-05 state budget on Tuesday that recommended cutting taxes but shrinking the Healthy Kids waiting list by just 10 percent, Democrats criticized the Republican governor's priorities.

Democratic legislators dusted off an obscure state law Wednesday and demanded a special legislative session on the issue. In effect, they will force Republicans to decide whether to spend $23-million more in state revenue this year to eliminate the waiting lists through June.

"When we have so many children in need and there is a simple, cost-effective solution, it is immoral not to do something about it," said Senate Democratic leader Ron Klein, D-Delray Beach.

The Democrats' message in Florida dovetails with the national party's attacks on the governor's brother, President Bush. The availability and affordability of health care coverage is a theme that will reverberate throughout this election year as Florida plays a key role in deciding who wins the White House and chooses a successor to retiring U.S. Sen. Bob Graham.

Gov. Bush said Wednesday the state already is seeking the maximum amount of federal money available this year for Healthy Kids.

"Democrats obviously can say whatever they want," Bush said. "I would look at it from a perspective of where we were and where we are now, which shows there are significant increases in the number of children in the varying programs. . . . I'm proud of our record."

The governor said he opposes investing too much more in Healthy Kids until the state examines whether some qualified children might be served through private health insurance plans.

A survey by the University of Florida last year found about one-third of families with children in Healthy Kids have access to private health insurance through a parent's employer. But the cost of such coverage would amount to 9.5 percent of the total family income.

"Anecdotally, the stories we hear all the time is that the cost is so prohibitive for a family that they would have to make a choice between groceries or insurance coverage," said Jennifer Kiser Lloyd, external affairs director for Florida Healthy Kids, the nonprofit corporation created by the Legislature to run the program.

Democrats capitalized on that reality Wednesday. Standing alongside young children on the Healthy Kids waiting list, Klein waved 52 petitions signed by Democrats demanding a special session _ more than the 20 percent required by law.

Under a little-used law evoked only three other times, Secretary of State Glenda Hood must poll all 160 state lawmakers by mail in the coming week on whether they are willing to participate in a special session to amend the Healthy Kids budget. At least 96 lawmakers must agree before a special session can be held.

The action brought rebukes from Republicans.

"I think any time there is a situation where people are usurping the power of a presiding officer is dangerous, and I would predict it would be awfully difficult to get the numbers necessary," said Senate President Jim King, R-Jacksonville.

"They're playing politics with children," said Rep. Allan Bense, R-Panama City, who is expected to be the next House speaker. "Do we call special sessions every time there's a perceived need by the Democrats? I don't think so."

Bush, King and Bense suggested they might consider spending money to shorten the waiting list this fiscal year during the regular legislative session that begins in March.

A revenue forecast scheduled for March is expected to show that an improving economy will provide the Legislature with several million dollars more to spend in 2004-05 than previously projected.

"If there are more monies that come inthat would be something I know the Legislature would look at for ways to lessen that impact," Bush said.

The projected demand for low-cost health insurance is evident in the very success of Healthy Kids. The program's enrollment, now at 292,082, has increased sixfold since the federal government began offering more than two-to-one matching money to Florida in 1998.

Launched in 1990 with bipartisan backing, Healthy Kids is designed to help families who make too much money to qualify for Medicaid but not enough to pay their children's health care costs on their own. A family of four can qualify for the program if it makes no more than $36,800 annually.

Among those on the waiting list is Kim Williamson's 8-year-old daughter, Ashleigh.

Kim Williamson said the family's health insurance disappeared last fall when she started making too much money to qualify for Medicaid.

"KidCare put me on a waiting list and told me it would be at least six months or longer," Williamson said.

A year ago, Williamson would not have faced a waiting list. Since the program's inception, the state has pretty much kept the door open for new enrollees in the program. But the open-door policy changed for the 2003-04 budget year. Facing the biggest budget crunch in decades, the state froze enrollment in the program at the previous year's levels.

_ Tallahassee bureau chief Lucy Morgan contributed to this report.