Florida appeals KidCare insurance premiums

After a US district judge rejected its arguments, Florida is going to an appeals court in a dispute over the state’s new guidelines on the program that provides health insurance for children.

Attorney General Ashley Moody’s office and lawyers for the National Institute of Health Care Administration on Monday filed a notice that they are appealing the May 31 ruling by US District Judge William Jung in the Supreme Court. of the 11th US Circuit.

As is typical, the announcement does not detail the arguments the government will present to the Atlanta-based appeals court.

The lawsuit, which Florida filed in February in Tampa, challenges guidelines related to coverage for the federal Children’s Health Insurance Program, which operates in Florida as KidCare. The program provides affordable health insurance to children whose families make enough money to qualify for Medicaid. In Florida, that means families paid $15 or $20 a month for coverage.

The new guidelines will prevent states from discontinuing coverage for non-payment of premiums after children are found eligible for the program. Eligibility is determined each year, so the government disagrees that the guidelines could lead to providing coverage for months without premiums being paid.

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With KidCare funded by the state, federal government and fees, the lawsuit said family payments play an important role in «maintaining the long-term sustainability» of the program. The state claimed that federal officials violated a law known as the Administrative Procedure Act and requested a preliminary injunction to block the guidelines.

But Jung denied the request for a preliminary injunction and dismissed the lawsuit against the federal Centers for Medicare & Medicaid Services and the US Department of Health and Human Services.

Jung decided that Florida needed to pursue an administrative challenge to the Centers for Medicare & Medicaid Services, rather than filing a case in district court. The federal agency issued the guidelines in the fall of 2023 in what is described in Jung’s ruling as a «frequently asked questions,» or FAQ document.

«CMS has released FAQs and requested modified CHIP plans from states that consider non-payment as an exception to continued compliance,» Jung wrote. «Rather than issue a modified plan or risk bad faith, Florida filed this action in federal court seeking a preliminary injunction. This Florida can’t do.»

He also wrote that «it is undisputed that any review of Florida’s APA (Administrative Procedure Act) applications will be very open to the proper interpretation of the Medicaid and CHIP statutes. The interpretation of these statutes falls within the realm of expertise.» of CMS, especially given the known problems with Medicaid and CHIP.”

Attorneys for the US Department of Justice have argued that the guidelines implement a federal law known as the Consolidated Securities Act of 2023, which made changes to CHIP. In a February court filing, Justice Department attorneys said the law requires the children’s program to comply with a «continuing eligibility requirement» in Medicaid that does not allow coverage to be dropped for nonpayment.

Florida’s program began in the 1990s, with subsidized insurance available to families with incomes up to 210 percent of the state poverty level. For example, a family of four at 200 percent of the poverty level this year will have an income of $62,400, according to federal figures.

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

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