Florida’s Governor Spends Taxpayer Money on Lawyers to Further Delay Covering Children

On June 22, 2023 Gov. Ron DeSantis signed HB121 a bill that expanded eligibility to cover children through the state’s KidCare program (the state’s version of the Children’s Health Insurance Program (CHIP)) to 300 percent of the poverty line. The bill unanimously passed both chambers of the Republican-controlled Florida legislature. The state of Florida has one of the highest rates of uninsured children in the country (7.4 percent in 2022) ranking 46th in the country.

And that was before Medicaid unwinding during which the state disenrolled the second largest number of children in the country – many of whom likely remain eligible. Net child Medicaid enrollment has declined in Florida by well more than half a million. There have been many heartbreaking stories of very sick children going without needed health coverage.

Despite these dire conditions facing Florida’s families, the state has still not implemented the CHIP expansion and instead has chosen to file litigation against the Biden Administration to prevent new federal protections passed by Congress for children enrolled in CHIP (and Medicaid) assuring them 12 months of continuous coverage nationwide. We have blogged about this here and here. The state wants to have the ability to terminate coverage for children when their families miss a CHIP premium payment during the 12 month period of continuous coverage. States can charge premiums under the new federal rules, and families can be required to pay one to enroll initially, but if a family misses a payment in months 2 thru 12 the child must be allowed to retain coverage.

Claiming that the state would face severe fiscal challenges otherwise, the state’s Medicaid agency filed a motion for a preliminary injunction in federal court in Tampa to block federal guidance implementing mandatory 12 months continuous coverage not just in Florida but nationwide. What warrants an emergency intervention by the court when it comes to NOT providing health insurance to children, you ask? The state argues that it would lose $1 million a month; less than 0.01 percent of the state’s overall annual budget of more than $117 billion. The legislature’s budget for the upcoming fiscal year also includes a surplus of $10 billion (with a b) dollars overall.

Judge William Jung, nominated to the bench by former President Trump, not only denied the preliminary injunction but entirely dismissed the lawsuit on May 31st, telling the state that the court lacked jurisdiction because the state must go through any CHIP administrative appeals process first. Unfortunately, the state has just appealed this decision to the U.S. Court of Appeals.

Confronted with the same situation, the state of Arizona chose a very different path and has already started enrolling kids in its CHIP expansion.

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.