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Decision Delayed On KidCare Premiums

Oct 27, 2017
Originally published on October 27, 2017 8:29 am

Members of a children's health-insurance panel said Thursday they wanted to help families in 48 counties who couldn't afford insurance premiums maintain coverage but delayed a vote on a plan until the panel receives details about how it would work and potential costs.

After lengthy debate, the Florida Healthy Kids Board of Directors agreed to allow its staff to work with the state Agency for Health Care Administration to find the 6,338 children living in those counties who were disenrolled from the state KidCare program in October and ask why they didn't pay premiums. If it was due to affordability, the plan is to waive premiums for October and allow them to re-enroll. The 48 counties were impacted by Hurricane Irma.

AHCA Secretary Justin Senior said there's an option called the “Chip In” program that could be used to pay the premiums, which range between $15 and $20.

It could cost an estimated $60,000, board members were told.

Senior said the state would be able to draw a federal match on the money.

Wendy Link, chair of the Florida Healthy Kids Board of Directors, suggested the vote be delayed until the state could finalize the details of the plan and the costs.

“I don't like to ask the board to vote on something you don't know exactly what you're voting on,” she said.

She also thanked the board members for their discussion on the issue, which was hastily added to the agenda of Thursday'smeeting in Orlando.

“Nobody here wants to see somebody, because of a hurricane, not be covered. We want our kids covered,” she said.

Following Hurricane Irma, Gov. Rick Scott agreed to extend for 30 days the deadline to pay children's health insurance premiums. The program offers low-income families access to subsidized insurance. Families with incomes above 200 percent of the federal poverty level can also enroll, but their premiums aren't subsidized. They are referred to as “full pay” enrollees.

That 30-day deadline expires Tuesday. Premium payments for November are also due by Tuesday.

A growing number of people would like the Scott administration to waive the premium requirements for October and November. Florida House Democrats were the latest group to lend their voices to the request.

In response, Senior asked the Florida Healthy Kids Board of Directors to consider the issue at Thursday's meeting.

Though no vote was taken, the majority of the board seemed unwilling to move forward on extending assistance through November. Florida Healthy Kids Executive Director Rebecca Matthews advised the board that based on applications, she expected operations in November to return to normal.

The board seemed hesitant to pick up the premium costs for all enrollees who fell off the program in October, with Link asking if it would be fair.

But new board member Jeff Brosco, a physician, said it would be ethical for the board to act and compared the situation to a parable of workers in the vineyard where Jesus said any laborer who accepts an invitation to work in the vineyard --- no matter how late in the day --- will receive an equal reward to those who have been faithful the longest.

“It's biblical,” Brosco said.

Moreover, he said from a public-policy point of view, it would be more efficient to absorb all the premiums as opposed to investing energy into determining why people didn't pay.

In a typical month, approximately 4,200 members are disenrolled due to non-payment in the 48 counties. Families can disenroll for a number of reasons, including if they age out of the children's health program or they obtain different coverage. 

During the discussion, Senior stressed that the state should tailor a solution to families who have subsidized coverage and who, after being contacted, confirm the were disenrolled because they couldn't afford to make payments.

The agency would need to ensure that none of the families who disenrolled were picked up by the Medicaid program.

Though the discussion focused on assisting subsidized children who fell off the program, Senior said “if people identified themselves to us already, then we could potentially use the CHIP IN program to pay for it.”

Beth Kidder, deputy secretary for Medicaid at AHCA and a member of the Florida Healthy Kids board, said the agency has been working on an amendment to its state plan and could include the “CHIP IN” option.

Other changes to the state plan the agency is mulling include a proposal to allow the agency to waive premium requirements as well as the authority to defer payment of premiums for 60 days. Currently, the state only is authorized to waive the financial requirements for 30 days.

The percentage of uninsured children in the state dropped from 14.8 percent, in 2009 to 6.2 percent in 2016. Despite the drop, Florida ranks third in the nation in the percentage of uninsured children.

Senior said there has been an “extraordinary effort across the board,” to provide health coverage to Florida children.

“It's all of our focus,” he said.