Even with government subsidized health insurance programs like Medicaid, the Children's Health Insurance Program and the Affordable Care Act, there are still nearly 100,000 kids in Florida that are uninsured.
Last summer, U.S. Senator Marco Rubio (R-FL) and U.S. Representative Gus Bilirakis (R-FL) worked with the U.S. Department of Health & Human Services to come up with regulatory changes that would give more options to this large gap of uninsured children and their families in Florida.
Rubio and Bilirakis were able to add provisions through the extension of the CHIP program that were signed into law by President Trump. These adjustments will offer another health insurance option for Florida families who don't qualify for Medicaid or CHIP, outside of the federal exchange for the Affordable Care Act. Health insurance premiums for children that qualify are also expected to drop from an average of $220 a month to $160-$170, Rubio said. These plans include medical and dental coverage per child per month.
"It took far too long to reauthorize CHIP," Rubio said in a statement last week. "As Floridians continue to feel the negative impacts of burdensome policies from the Obama administration, this is an important step toward bringing affordable coverage within reach of all Florida families and rolling back unnecessary regulatory barriers that drive up health care costs."
CHIP provides health coverage to eligible children through Medicaid and its own programs. The health insurance plans are administered by individual states according to federal requirements.
Florida had two general categories for CHIP enrollees prior to the Obama administration for children whose families met the income criteria. The first group had rates were subsidized by the state and federal governments. The second option allowed families above the poverty level to "buy in" to the program, often described as "full pay" enrollees, which allowed the state to blend the risk pools of both categories and create a "single, much healthier risk pool," Rubio said.
But that changed in 2015, when plan administrators had to make changes because of new insurance regulations associated with the Affordable Care Act, which eliminated the blending of these two risk pools. These new rules also required plans cover more benefits, including emergency-room visits and preventive screenings and vaccines. They also prevented plans from limiting spending on essential health benefits for children.
Federal health officials said the new regulations improved coverage. But they came with a cost as premiums doubled from 2015 to 2016.
"It's a good measure that this option is written in statute," said Ann Swerlick, an attorney and analyst with the Florida Policy Institute in Tallahassee. "My understanding is that this was already going on in other states, but it's good to have that carved in statute in Florida to keep lower rates for buy-in families."
Rubio said there are "many working families that rely on Florida CHIP's Sunshine Health Stars Plus Plan."
"This is a vital program for families whose income level disqualifies them from Medicaid and traditional CHIP, but who still need affordable health insurance for their children," he said in a statement.
Florida Healthy Kids is a public-private organization which offers health insurance to children ages 5 to 18 whose families make too much money to qualify for Medicaid. As of January, the program covered 2.4 million children in the state. Healthy Kids estimates that there are 257,000 uninsured children in Florida, but 147,000 of those have access to free or low-cost coverage. The left over 100,000 children are who these new provisions to CHIP should be able to help, Rubio said.
But some of the federal requirements from 2015 could be troublesome with families with special needs children, like the removal all annual and lifetime dollar limits on essential health benefits, Swerlick said.
"Overall, this will provide another option for some families, and in some cases it could be more affordable for them," Swerlick said. "But it's hard to imagine that all 100,000 families will take this up. And it's worth noting that because of the changes in 2015, there could be the potential for more roll backs in these benefits. We just don't know."