Judge won’t order state to implement expanded access to KidCare
Circuit Court Judge Joshua Hawkes in Tallahassee, appointed by Gov. Ron DeSantis, wrote in a four-page ruling that those suing the state must first pursue their claim through a state administrative court.
This ruling is yet another setback to efforts to expand health care coverage to children, initially promoted by Republican legislative leaders, including Republican gubernatorial hopeful and former House Speaker Paul Renner, to make the state more affordable for working families.
The lawsuit was filed earlier this year against Florida Healthy Kids and the Agency for Health Care Administration by three Florida families with the help of Florida Health Justice and the National Health Law Program.
In addition to requiring those suing to first go through state administrative court, Hawkes said the lawsuit fell short of other legal requirements.
"While Petitioners may regard that decision as unfair, the Court does not find that they are without remedy, although the Legislature could have barred a remedy if it chose to. Instead, Petitioners simply do not have a cause of action in this Court regarding their coverage decisions," Hawkes wrote, adding that state administrative court orders and agency final orders can be appealed to a state appellate court.
Florida Health Justice did not immediately respond to Florida Phoenix's request for comment.
Hawkes in his decision agreed with the state that the Florida Healthy Kids Corp., whose board administers the Florida KidCare program along with the state, could not be sued for "failure to make health services available to any person."
The ruling followed a court hearing Hawkes held on the case last week.
Florida KidCare is the state's version of the federal Children's Health Insurance Program, or CHIP. It's an optional Medicaid expansion program for children aged 5-18 whose families earn too much to qualify for the traditional Medicaid program.
Unlike traditional Medicaid, which is free for enrollees, Florida KidCare enrollees who qualify for a subsidized plan are required to pay small monthly premiums; according to the website, it's $15 or $20 a month per household. They also make co-payments for services.
Families lose access to the subsidized health insurance plan once their income exceeds 200% of the federal poverty level, or $54,640 for a three-person household.
The 2023 law ostensibly allows a family of three to earn up to $81,960, or 300% of the federal poverty level, and continue to qualify for the children's health insurance coverage.
Florida Health Justice failed to convince Hawkes the state was obligated to provide the coverage because the federal government had approved a Medicaid waiver submitted by the state to expand the program.
That approval came Dec. 2, 2024, after the federal government passed a law requiring children participating in Medicaid and the state Children's Health Insurance Program to remain enrolled in the programs for a year. The law was implemented through a rule finalized in 2025.
The state has filed three lawsuits in federal court over the continuous eligibility requirement.
It filed a different lawsuit in February that it subsequently withdrew.
'Conversations with CMS'
AHCA Deputy Secretary for Medicaid Brian Meyer in April told members of a joint legislative spending panel that he was having "conversations with CMS about this, so we are actively trying to get to an agreeable place between both parties so we can move this program."
CMS is the federal Centers for Medicare and Medicaid Services.
Meyer was getting pushback from Republican and Democratic members of the Joint Legislative Budget Commission who were pressing him about the DeSantis administration's positions on children's health insurance.
The administration has blamed the federal government for the failure to expand Florida KidCare and it has ignored the continuous coverage requirement, dropping children from the Florida KidCare program whose families didn't pay premiums.
At one point, the state had removed in one year more than 43,000 children from the program whose family had not paid premiums. More than 17,000 of them were never re-enrolled.
The state has filed at least three challenges over the requirement, one of which, filed in Pensacola federal court, still is being litigated.
https://www.yahoo.com/news/politics/articles/judge-won-t-order-state-235452218.html?fr=sycsrp_catchall
