No Free Lunch for KidCare Expansion
Even a modest effort to expand Florida KidCare to cover one of the nation’s largest populations of uninsured children is plagued by bureaucratic snags, the Senate’s Health and Human Services Committee was told Thursday.
A proposal to initiate so-called express-lane eligibility for to draw more kids into state-subsidized health insurance could cost as little as $165,000 in state money -- drawing down potentially millions of dollars in federal funding, program analysts say.
Express-lane allows states to use information from one public program to determine eligibility in other state-backed services. But that’s where the simplicity ends, lawmakers learned.
“I guess I’m kind of flabbergasted,” said Sen. Nan Rich, D-Weston, who has been seeking to pull more children into the program.
Rich and other senators have been looking at using the federal free lunch program application to alert parents to their children’s possible eligibility for KidCare, since the approach has been used successfully in Broward County.
But Jennifer Lloyd, outreach director for Florida Healthy Kids Corp., which oversees KidCare, said Florida’s 67 counties all have different applications for the federal lunch program – making it virtually impossible for the state to easily employ it for determining KidCare eligibility.
“It’s a unique, county-by-county form,” Lloyd said of the free-lunch application.
Rich responded, “That makes absolutely no sense.”
But she conceded lawmakers are back to the drawing board in trying to figure out a way to expand KidCare – even slightly.
Although 259,258 children are currently enrolled in KidCare, making them eligible for state-paid doctor visits, critics say that level falls short of what it could be with 1 million Floridians out-of-work and unemployment at a 35-year high.
The Office of Program Policy Analysis and Government Accountability (OPPAGA) has cautioned that Florida officials are uncertain about how much federal money the state could draw through “bonus payments” made to states that implement at least five of eight specific strategies to boost children’s health insurance enrollment.
Presumptive eligibility, which would allow children to begin receiving services while their eligibility is determined, could cost $63 million in state funding; another $21 million in state cash would be needed to double to 12 months the time frame children aged 5 to 19 could receive Medicaid health coverage, state analysts found.
The express-lane approach is the cheapest of the potential upgrades – but became plagued Thursday by the application problem.
While warning about the upfront costs of seeking more federal money, OPPAGA also said that bringing more families to Florida KidCare would likely result in the state finding more children available for Medicaid.
Unlike KidCare, Medicaid is an entitlement program that can’t be limited by available dollars.
The state is currently facing a $1.7 billion projected deficit in the Medicaid program heading into next year.
Meanwhile, the health care overhaul making its way through Congress also could have a profound effect on Florida’s health and human services programs. KidCare also has drawn new political shading, with Gov. Charlie Crist last fall appearing to distance himself from the program’s success in criticizing the Obama administration’s push to include a government-paid “public option” in the health care overhaul.
At the time, Crist defended KidCare as a “limited” health insurance plan. Supporting efforts to expand the program could hurt the Republican governor in his duel with former House Speaker Marco Rubio for their party’s U.S. Senate nomination.