Increasing Access to Health Care among Children through KidCare
The Foundation believes that in order to build a healthy South Florida community all children should have access to health care. Because health services are relatively expensive, children's access to care is largely dependent on whether or not they have health insurance. Unfortunately, far too many children are not covered and therefore, do not receive needed care. Given that Florida has one of the highest numbers of uninsured children in the nation and given that most of these children are actually eligible for existing public-funded insurance program, the Foundation identified increasing enrollment and funding for KidCare a public policy priority.
Florida KidCare is the state’s health insurance program for low-income uninsured children under age 19. It is comprised of four components including Medicaid for children, Children’s Medical Services (for children with special health needs), Medikids (ages 1 – 4) and Healthy Kids (ages 5 – 18). Three state agencies and the Florida Healthy Kids Corporation, a non-profit organization, are responsible for administering the Florida KidCare program.
In 2007, the Foundation partnered with Florida CHAIN and Human Services Coalition to advocate for children’s health insurance by educating decision-makers about the importance of KidCare and need to adequately fund the program allowing eligible children to enroll. A comprehensive campaign including but not limited to town hall meetings, postcards, op-eds, petition drives, and family testimonies were conducted throughout the year in advance of the 2008 legislative session. That year, legislation was enacted to increase coverage for 38,000 more children. Increases in funding have occurred in the past two sessions as well indicating a general commitment from the state legislature to reduce the number of uninsured children in the State. Over 250,000 children participate in the program but hundreds of thousands remain uninsured.
Following the passage of the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009, the Foundation decided to shift its focus to working with advocacy partners to push for administrative changes that would address enrollment and retention barriers. CHIPRA 2009 not only provided states with additional funding to cover additional children but included fiscal incentives (i.e., bonus payments) for states to enroll eligible low-income children in Medicaid. States could qualify for a bonus per child based on how far actual enrollment exceeds target levels. To be eligible for the bonus payments, states must have adopted a minimum of 5 out of 8 eligibility simplification efforts (including 12-month continuous eligibility, elimination of the asset test, elimination of the in-person interview, use of a joint application for Medicaid and CHIP, streamlined renewal, presumptive eligibility, Express Lane eligibility and premium assistance subsidies).
In March 2009, the Foundation created and disseminated a Health E-script advocating for KidCare improvements to committee members of the Senate’s Health Regulation; Banking and Insurance; Health and Human Services Appropriations; Policy & Steering Committee on Ways and Means and the House’s Health Care Services Policy Committee; Insurance, Business & Financial Affairs Policy Committee; Health & Family Services Policy Council; Human Services Appropriations Committee. Click here for KidCare Health E-script.
The federal government awarded $300 million in 2011 performance bonuses to 23 states for improving their children’s health care programs, but Florida missed out as a result of officials’ inaction. Florida hasn’t taken actions needed to enroll more children or streamline procedures to keep kids covered, which would make the state eligible for these additional federal dollars. The Foundation will continue to work towards increasing enrollment by advocating for increased funding, improving community outreach efforts, and adoption of eligibility simplification efforts potentially bringing millions of federal dollars to the State.