KidCare Expansion Status | December 2024: Federal Government Approves Expansion in Florida

Background

For background information regarding the KidCare expansion proposal in Florida, please see here: KidCare Expansion Status: What’s the Holdup and Who is Affected?

What’s the Latest?

On December 2, 2024, the Centers for Medicare and Medicaid Services (CMS) approved, effective immediately, Florida’s request to increase the eligibility threshold for its subsidized KidCare program to 300% of the Federal Poverty Level (FPL).  This approval allows Florida to charge monthly premiums for the expanded population (using a household of 4 as an example) as follows:

FPL                           Annual Income                 Premium

210-235%                 $65,520 – $73,320          $   60

235-255%                 $73,320 – $79,560          $   95

255-275%                 $79,560 – $85,800          $ 145

275-300%                $85,800 – $93,600           $ 195

CMS’s approval also provides:

• Florida must provide twelve (12) months of continuous eligibility for Medicaid and KidCare enrollees, even in the event of missed premium payments. This is required by federal law and regulation, see Section 5112, Consolidated Appropriations Act, 2023; CMS, Department of Health & Human Services, Medicare and Medicaid Programs: . . . Medicaid and CHIP Continuous Eligibility (Nov. 27, 2024). CMS said it would require Florida to provide continuous eligibility as a condition of its waiver approval even if it was not required by federal law, based upon studies showing that continuous health coverage improves health outcomes.
• Premiums and copays combined cannot exceed five (5) percent of a family’s income.

• Yearly premium increases may not exceed the Consumer Price Index (CPI).

• Florida must accept the terms and conditions of CMS’s approval by January 1, 2025.

What’s the Next Step?

It’s now up to Florida’s Agency for Health Care Administration (AHCA), an agency that reports to Governor Ron DeSantis, to implement the expansion.  State legislators may also be able to help.  To urge them to act immediately, contacts for these individuals are provided below:

Ron DeSantis, Governor

Email: Click here or GovernorRon.DeSantis@eog.myflorida.com

Phone: (850) 717-9337

Jason Weida, Secretary of the Florida Agency for Health Care Administration

Email: jason.weida@ahca.myflorida.com

Phone:  850-412-3600

Ben Albritton, Florida Senate President 

Email: Click here

Phone: (850) 487-5229

Daniel Perez, Speaker of the Florida House of Representatives

Email: Click here

Phone: (850) 717-5116

Find your state senator:  Click here

Find your state representative: Click here

For questions, please contact Lynn Hearn, hearn@floridahealthjustice.org