- The Social Services Estimating Conference discussed the expenditure overview for the state-subsidized health insurance program KidCare on Monday, which will see increased costs due to new eligibility legislation.
- House Bill 121 raised income eligibility limits for KidCare, leading to a projected increase of over 16,000 children in enrollment in the fiscal year 2023-2024.
- The estimated additional state and federal expenditures are approximately $9.95 million annually, including one-time administrative costs and recurring costs for enrollee services.
- The bill also requires the development of multiple-tiered family contribution levels based on income, and the overall caseload projections for KidCare show a reduction compared to previous estimates.
The Social Services Estimating Conference met on Monday morning to provide an expenditure overview for the state-subsidized health insurance program KidCare, which is expected to see a slight rise in total overhead costs following the recent passage of eligibility legislation.
House Bill 121, adopted by Gov. Ron DeSantis in May, raises the income eligibility limits within the program from 200 percent to 250 percent of the federal poverty level (FPL), effective July 1, 2023, and from 250 percent to 300 percent, effective July 1, 2024.
However, there will also be additional state and federal expenditures amounting to approximately $9.95 million annually, as projected enrollment is expected to rise by more than 16,000 children in the fiscal year 2023-2024. State economists estimate one-time administrative costs of $800,000 for implementing the new eligibility tiers and recurring costs of $526,522 for enrollee services.
Moreover, the Agency for Health Care Administration (AHCA) will incur one-time administrative costs to update the Florida Medicaid Management Information System, while the direct economic impact on the private sector may result in reduced use of employer-based dependent child coverage as newly eligible families may opt for subsidized KidCare coverage instead.
“That is to account for, as we said, the effects of House Bill 121, where now that the coverage level goes up for these kids and these programs … that’s the difference that we have not had before, where we have a premium change,” said Tom Wallace, Deputy Secretary for Health Care Finance and Data at AHCA.
Under the bill, the total monthly family payment for participants is $15 or $20 for families with incomes between 133 percent and 200 percent of the FPL. The per-child monthly premium rate is $210.18 for full-pay MediKids coverage and $259.50 for full-pay Healthy Kids coverage, including dental coverage.
The annual caseload projections for the entire KidCare Program are lower than the August 2022 estimates across all years, with reductions estimated to be the most concentrated within the first two forecasted years (by 23,815 in FY 2022-23 and by 33,409 in FY 2023-24) before stabilizing with an annual loss to the prior estimate of about 6,021 per year.
Although the forecast continues to show a significant jump in the Florida Healthy Kids enrollment beginning in late FY 2022-23 and continuing through FY 2023-24, it is not enough to overcome the lower expectations for the overall Program throughout the forecast horizon, according to legislative staff.
“Based off of all of this, comparing it to the appropriations, we still have a little bit of a surplus in terms of the general revenue though we do show a little bit of a deficit in authority for the family contribution,” continued Wallace.
The measure also requires the Florida Healthy Kids Corporation and the AHCA to develop a minimum of three, but not more than five, tiered family contribution levels, meaning that families who qualify for the Florida Kidcare program would have different levels of premiums and co-payments based on their income levels.
Florida KidCare has four forms of coverage: MediKids, Florida Healthy Kids, Children’s Medical Services Managed Care Plan, and Medicaid, each with its own set of benefits, co-payments, and eligibility conditions. The Children’s Medical Services Managed Care Plan is for children with unique healthcare requirements, while Medicaid is for low-income children who fulfill certain qualifying criteria.
As of March, 4,883 children are enrolled in subsidized MediKids, with 3,280 children enrolled in MediKids under the full-pay option. 76,340 children are enrolled in subsidized Healthy Kids, while 21,650 children are enrolled in Healthy Kids under the full-pay option.
In total, 2,466,597 children are enrolled in the Medicaid program, according to a Senate analysis. Florida KidCare is funded by both the state and federal government and administered by the Florida Department of Children and Families.
It would be helpful for the reader to know what the income models are in dollars, rather than percentages.