1. Opinion

Editorial: Filling a gap in children's health care

Published Mar. 29, 2013

In typical Tallahassee fashion, money is trumping children's health care in a fight over a House bill that would close a gap in the state's medical safety net. The bill, HB 689, would provide a health insurance bridge for children through a government-funded program when a parent loses coverage due to a job loss or doesn't have insurance for other reasons. Providing this peace of mind to Florida families wouldn't cost much — the highest estimate is $15 million annually — but the price tag appears to be stalling the bill's progress.

Florida KidCare includes a range of low-cost children's health insurance programs that are funded through a federal-state partnership. Children up to 19 years old can qualify for government-subsidized health care coverage of one form or another if their families make up to 200 percent of the federal poverty line. But due to the lag time it takes to determine a family's KidCare eligibility, which usually occurs within 45 days, there can be a dangerous gap for uninsured children in medical need.

A bill by Rep. Gayle Harrell, R-Stuart, would fix this by letting children receive medical treatment while their application is under review. It would create a presumption in the law that a child is eligible for a KidCare program if the family applies through a county health department, a Head Start program or some other designated low-income service provider.

The change would go into effect Jan. 1. That would correspond to a new rule that goes into effect under the federal Affordable Care Act, giving hospitals the option of providing presumptive eligibility to children under 19 years old. Under the House bill, presumptive eligibility would be available through hospitals and others institutions qualified to make that judgment, giving low-income children as many options as possible to be insured.

There is substantial bipartisan support for the measure. Last month the bill passed a House committee unanimously, but it has two more assigned committees. In the Senate, the companion bill SB 548 sponsored by Sen. Nancy Detert, R-Venice, has not been heard in any of its three committees. The problem seems to be its estimated cost. KidCare and the Federally Qualified Health Centers puts it at less than $1.9 million annually. But House analysts say it will cost the state $14.3 million, and the Agency for Health Care Administration estimates the cost at about $15 million.

These higher estimates don't take into account the savings from keeping children healthy. Most children who apply for KidCare are eligible. Making sure they get essential medical care while their application is processed could prevent expensive medical emergencies down the road. As lawmakers debate how to broaden the state's medical safety net for all uninsured Floridians, this should be an easy fix to make.