Herald-Tribune

Feds ask to dismiss Fla. kids’ health insurance suit

- Jim Saunders

TALLAHASSE­E — The Biden administra­tion on Tuesday urged a judge to dismiss a lawsuit in which Florida has challenged federal guidelines for a program that provides subsidized health insurance to tens of thousands of children.

The filing in federal court in Tampa by U.S. Department of Justice attorneys was the latest move in a months-long battle over guidelines issued last year for the Children’s Health Insurance Program, which operates in Florida as KidCare.

The program provides low-cost health insurance to children whose families make too much money to qualify for Medicaid. In Florida, that has meant families have paid $15 or $20 a month for coverage.

Florida filed the lawsuit in February, challengin­g guidelines issued by the federal Centers for Medicare & Medicaid Services that would prevent states from cutting off coverage for non-payment of premiums after children have been found eligible for the program. Eligibilit­y is determined each year, so the state contends the guidelines could lead to coverage being provided for months without premiums being paid.

With KidCare financed by the state, the federal government and premiums, the lawsuit said family payments play an important role in “maintainin­g the long-term stability” of the program.

“Requiring participan­ts to make modest contributi­ons to the cost of health insurance also reflects a conscious policy choice by the Florida Legislatur­e, which concluded that Florida residents are best-served when those receiving state-subsidized health care retain a measure (of ) accountabi­lity for, and investment in, the benefits they receive,” the lawsuit said.

But the Biden administra­tion argues that the guidelines properly carry out a federal law known as the “Consolidat­ed Appropriat­ions Act, 2023” that made changes to the Children’s Health Insurance Program. In a February court filing, Justice Department attorneys said the law required the children’s program to match a “continuous eligibilit­y requiremen­t” in Medicaid that does not allow dropping coverage for non-payment of premiums.

“These changes were intended to reduce ‘churn’—cycles of terminatio­n and re-enrollment that increase administra­tive costs and cause coverage lapses for vulnerable children,” said the February document, which was a response to a Florida request for a preliminar­y injunction.

The Biden administra­tion’s motion to dismiss the case filed Tuesday and the February document also raised a series of other arguments, including that such disputes should go through an administra­tive process.

Florida’s children’s health program dates to the 1990s, with subsidized insurance available to families with incomes up to 210 percent of the federal poverty level. As an example, a family of four at 200 percent of the poverty level this year would have income of $62,400, according to federal calculatio­ns.

The Legislatur­e and Gov. Ron DeSantis last year approved a bill that would expand eligibilit­y in the subsidized health program to 300 percent of the poverty level with higher premiums than have been charged in the past. The expansion requires federal approval, and court documents said the state would have to comply with the new guidelines to get approval.

“CMS (the federal Centers for Medicare & Medicaid Services) indicated that it would not approve Florida’s proposed expansion without accompanyi­ng modificati­ons to Florida CHIP’s (Children’s Health Insurance Program’s) continuous eligibilit­y provisions, namely, the provisions that allow the state to disenroll an eligible child for nonpayment of premiums during the continuous eligibilit­y period,” the lawsuit said.

Florida contends that federal officials have misinterpr­eted the law that made changes in the children’s health program. Also, it argues that federal officials have violated a law known as the Administra­tive Procedure Act in the guidelines.

U.S. District Judge William Jung held a hearing April 18 on Florida’s request for a preliminar­y injunction but had not issued a ruling as of Wednesday morning, according to a court docket.

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