It Looks Like Florida is Cutting Children Off CHIP in Violation of Federal Rules

While children are losing Medicaid coverage nationwide due to the unwinding process, new data reveals that Florida has disenrolled 22,576 children from its Healthy Kids CHIP program since January 1, 2024, when new federal protections requiring states to provide 12 months of continuous coverage in Medicaid and CHIP went into effect, which included barring states from disenrolling children for failure to pay CHIP premiums during that 12 month period.

Florida is one of just nine states nationwide that charges premiums to children below 150 percent of the poverty line which equates to $38,730 for a family of three. Parents and adults at this income level who are currently receiving subsidized coverage through enhanced premium tax credits in the Marketplace in Florida do not pay premiums. As research has well documented, premiums create barriers to enrollment for low-income families; children whose families can’t pay premiums are most likely now uninsured. Seven states have dropped all premiums in CHIP at any income level over the past few years in recognition of the barriers they pose for low- and moderate-income families.

Florida is the only state in the country that we are aware of that is currently disenrolling children from separate state CHIP programs for nonpayment of premiums subsequent to January 1, 2024, in contravention of federal law.

The data became available as a consequence of a public records request by the Florida Health Justice Project. Coincidentally, it was released just two days before a hearing in federal court on the case State of Florida v Becerra, Florida’s attempt to eliminate an important piece of the new federal guarantee of 12 months of continuous coverage for children in CHIP regardless of where they live. My colleague Edwin Park and I have blogged about this case here and here. This week’s hearing is on Florida’s motion for a preliminary injunction.

Meanwhile, children in Florida continue to lose coverage through the Medicaid unwinding – including many very sick children who were disenrolled on Easter. The number of children enrolled in Florida’s Medicaid program has declined by 485,269 as of March 2024 as the state is close to completing its unwinding process.

While Florida is not alone in rapidly disenrolling children from Medicaid during the unwinding process – many of whom likely remain eligible – families in the state should know that Florida is distinguishing itself in an apparent violation of federal law by kicking children off CHIP as well. But with the litigation, the state’s efforts to block children from retaining affordable health coverage are not stopping at its borders; depending on how it is framed, a ruling in Florida’s favor could give all states the green light to terminate the coverage of CHIP kids if their parents miss a premium payment. We shall see what the court decides.

Joan Alker is the Executive Director of the Center for Children and Families and a Research Professor at the Georgetown McCourt School of Public Policy.