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State Lawmakers to Consider Expanding Child Health Coverage

Bipartisan legislation that will be filed in the coming year aims to extend state-subsidized health insurance coverage to children of certain legal immigrants and the kids of state employees in Florida.

Florida shares the cost of its subsidized health insurance program for children - KidCare - with the federal government. But in the past, Washington didn't pay to cover the children of legal immigrants who have been in the country less than five years.

Not wanting to pay the full cost of covering those children without a match from the feds, Florida stopped enrolling new legal immigrant children in 2004. Efforts by advocates for immigrants and for children since then to restore that coverage have failed.

But now, the federal government will help pay for that coverage, and children's advocate Karen Woodall said it would make sense for Florida – a state with a high number of immigrants – to take advantage of the newly available money from Washington to add those children to the KidCare rolls.

“We need to enroll those kids like everyone else,” Woodall said Thursday.

The federal government still won't help pay for subsidized health care coverage for the children of state workers unless they are eligible for Medicaid. While some state workers are eligible for Medicaid, many make too much money, but still not enough to afford health coverage, advocates say.

The federal government assumes that states will pay government workers enough to cover health care for their children, or offer them insurance. In Florida, that's not always the case, Woodall said.

“The state's not doing its job in making health care coverage available,” she said.

Legislation currently in bill drafting filed by Sen. Nan Rich, D-Weston, and Rep. Jimmy Patronis, R-Panama City, would add the children of legal immigrants and the children of state workers to those automatically eligible for subsidized health insurance. Children people in the country illegally would remain ineligible for any state health care coverage.

The state would be on the hook for the full cost of the subsidized portion of coverage for state employees' children – the federal government still won't match those payments, Woodall said.

The measures would also expand Medicaid eligibility to include pregnant women making up to 200 percent of the federal poverty level. Currently pregnant women who make up to 185 percent of the poverty level are eligible to have Medicaid pick up certain prenatal and postpartum medical costs. Newborns are covered by the state in families up to 200 percent, so the number should be the same for pregnant women, advocates have argued for a few years.

Efforts to expand KidCare or make it easier for parents to get their children in and keep them there have appeared in nearly every legislative session for several years. This past year, lawmakers tweaked the law dealing with eligibility in an effort to make it easier for parents to keep their kids in the program and to prove their eligibility.

Just how much an expansion to pick up children of legal immigrants and state workers would cost isn't clear – because there's no definite handle on how many of those children are out there.

“What we know is we have 800,000 uninsured kids and the majority are under 200 percent of poverty – some of those are immigrants,” said Woodall.

For every extra 29 cents the state would spend on the program, it would be getting back 61 cents of tax money from Washington. Woodall argues that's tax money that Floridians have already sent to the federal government and if the state doesn't make the change to get the extra federal dollars, that money would go somewhere else.

“The federal government has said that if we do these things in states (add children to the rolls), we get bonus money, so there are incentives to do this,” Woodall said. “We will not take advantage of any of those bonus dollars if we do not do this.”

The state currently allocates enough money to KidCare to boost enrollment without having to cap the number of kids the program can cover – which means lawmakers may be able to increase eligibility without having to put more money into the program. If too many newly eligible children actually signed up, the Legislature would either have to then allocate additional money to the program or cap enrollment.

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