Florida may have a plan to address the increasing number of children who lack health insurance, but it remains to be seen whether the proposal will get funded.
The state Agency for Health Care Administration wants $16.3 million to help insure an additional 22,000 children in the Florida Healthy Kids program and lower the costs for some children already in the program, according to a legislative budget request.
Florida officials hope to use the money to take advantage of a federal change that allows the state to return the program to its pre-Obamacare days. Though mostly administrative in nature, Florida Healthy Kids Chief Executive Officer Rebecca Matthews said the moves would lower premiums to $170 a month for so-called full-pay children, which could attract more children to the program.
But House Speaker Jose Oliva is frustrated by the amount of money taxpayers spend on health care and has made lowering costs a top priority. While he says he's troubled by the rise in the uninsured rates, he may nevertheless be hesitant to approve increased funding.
"To say 'I'm troubled by it, I'll dump a whole bunch more money in it,' is to say, 'The next presiding officers will then have to come back and try to figure it out because the prices will continue to rise,' " Oliva told the News Service of Florida last month.
The legislative budget request comes on the heels of a Georgetown University Center for Children and Families report this month that showed about 325,000 uninsured children in Florida in 2017, up from 288,000 in 2016. That put Florida's overall uninsured rate for children at 7.3 percent.
It was the first time the percentage of uninsured children had increased in the last decade, according to the analysis.
Prior to the Affordable Care Act, better known as Obamacare, the Florida Healthy Kids program provided subsidized insurance coverage to low-income children ages 5 to 18 and access to managed-care plans with children-centric benefits. It also allowed children who lived in families that earn more than 200 percent of the federal poverty level to have access to the same plans, but their premiums weren't subsidized with federal funds.
All children enrolled in the program, regardless of their incomes, had access to the same managed-care plans.
After 2015, though, the state was required to revamp the program so full-pay children were offered Obamacare-compliant policies. The policies have different benefits and were subject to co-insurance requirements and deductibles.
As a result, full-pay enrollment in the program plummeted from a high of 36,000 to a low of 10,000 children in January 2017.
The Bipartisan Budget Act of 2018, though, exempts Florida Healthy Kids policies from the Obamacare requirements and allows states to again combine the programs. Though full-pay children wouldn't have their monthly premiums directly subsidized with federal funds, the children would be able to tap into the child-centric health coverage that the state was able to negotiate on behalf of children whose premiums are subsidized.
Matthews said including full-pay children in the same program — and insurance risk pool — as the other children will lower monthly premium costs from $245 to $170.
Matthews said she was lobbying the Legislature, the incoming DeSantis administration and Chief Financial Officer Jimmy Patronis, who makes appointments to the Florida Healthy Kids Corp. board of directors, on the funding request.
Matthews' lobbying appears to have had some success in the Senate, where Health and Human Services Appropriations Chairman Aaron Bean expressed support for the proposal this week.
"That's something in the future that we can look at as a committee going forward to make sure we are doing all we can do that everybody has access to health insurance," said Bean, R-Fernandina Beach.