“This is a tale of two states.” Joan AlkerExecutive Director of the Georgetown University Center for Children and Families.
The differences aren’t just two states on their own paths. They mark a broader landmark moment as the country rethinks how government works for families in the wake of the coronavirus pandemic, Alker said. The divide also highlights policy issues at stake in the 2024 presidential election.
Republican-led legislatures in Arizona and Florida have worked together in bipartisan cooperation to pass bills in 2023 to expand their states’ Children’s Health Insurance Programs, or CHIP, to cover people under the age of 19 whose families make too much to qualify for Medicaid.
Then, last year, Florida Governor Ron DeSantis (R) and Arizona Governor Katie Hobbs (D) signed bills increasing the amount of household income that can qualify for their state’s CHIP program.
Arizona began enrolling newly eligible children in March. The state Biden Administration Initiatives Give CHIP protections similar to those in the Affordable Care Act, such as eliminating annual and lifetime coverage limits and eliminating lockouts when families don’t pay their premiums.
Arizona’s CHIP program; It’s called Kids CareThe state stopped collecting monthly premiums in 2020 at the height of the pandemic and has not yet resumed them, and state officials are considering whether it’s worth the expense of administering and collecting the premiums given that new federal rules prohibit states from disenrolling children for non-payment, he said. Marcus JohnsonDeputy Director of the State Medicaid Agency.
“We’re trying to understand whether the benefits are worth squeezing out,” he said.
In contrast, Florida has not yet opened expanded enrollment and is the only state to have filed a federal lawsuit challenging the Biden administration’s rules. Keeping your child enrolled for 12 months Even if your family doesn’t pay the insurance.
A judge on May 31 dismissed Florida’s lawsuit and said the state can appeal to federal regulators. The state’s CHIP expansion now awaits approval from federal regulators before it can enroll newly eligible children.
“Eligible children should not face barriers to enroll in CHIP or be at risk of losing the coverage they rely on,” said Sarah Ronald, a spokeswoman for the federal Department of Health and Human Services.
Florida’s CHIP expansion calls for a large increase in premiums, followed by a 3 percent increase each year thereafter. The state estimates the expansion will cost an additional $90 million in the first year and hopes to raise about $23 million in new premiums to subsidize the expansion, as it’s called. Florida Kidcare.
But Florida officials said complying with a provision that prohibits disenrolling children for unpaid premiums would cost the state $1 million a month. FY2024 Budget Allocate $46.5 billion to healthcare and projects $14.6 billion surplus whole.
Florida officials ignore federal regulations At least 22,000 children were abducted. More than 6 million people have had unpaid premiums collected from CHIP since the anti-withdrawal rule went into effect Jan. 1, according to public records obtained by the Florida Health Justice Project, a nonprofit advocacy group.
Governor DeSantis’ office and the Florida Department of Medicaid Administration did not respond to repeated requests for comment about CHIP from KFF Health News. In court documents, Florida said its CHIP plan is an “individual responsibility program,” which the administration said is a “bridge from Medicaid to private insurance.” Social mediaThis is to familiarize families with premiums, cost sharing, and the risk of losing coverage if they don’t make payments.
Some Floridians, like Emily Dent of Cape Coral, believe the premium increases proposed in the state’s expansion plan will create a financial burden rather than pave the way to self-sufficiency.
Dent, 32, said her 8-year-old son, James, was taken off Medicaid in April because the family’s income was too high. James would be eligible for CHIP under Florida’s proposed expansion, but the $195-a-month premiums would be a financial strain on the family, Dent said.
Dent said leaving James uninsured was not an option: he is severely disabled due to a rare genetic condition called Pallister-Killian syndrome and requires round-the-clock care.
“He’ll have to get health insurance,” she says, “but that will eat into my savings that I was saving up to buy a house someday.”
According to the study: Insurance premiums could be a barrier for many families It is possible to obtain and maintain CHIP coverage even if your premiums are low.
And the premiums don’t offset many of the costs of running the state’s program, he said. Matt JewettShe is director of health policy for the Arizona Children’s Action Alliance, a nonprofit that promotes health insurance access for Arizona children.
He noted that after deducting premiums collected, the federal government pays 70 percent of the program’s costs in Florida and 75 percent in Arizona.
“The premium is based on an ideological belief that families need to take on risk, rather than a practical means of paying money to support the program,” he said.
Republican-leaning states aren’t the only ones implementing monthly or quarterly CHIP premiums. 22 statesPremiums are imposed in states across the country, including Democratic-leaning states such as New York and Massachusetts.
States have had broad discretion over how they run CHIP since it became law in 1997, including the power to collect premiums and cut off coverage if recipients don’t pay, which he says is part of what makes the program so successful. Jennifer TolbertDeputy Director of Medicaid and Uninsured Programs at KFF, a nonpartisan health research organization.
“The ability to create CHIP as a separate program independent of Medicaid enabled and fostered bipartisan support, especially in conservative states,” Tolbert said.
In the decades since CHIP was enacted, the government’s role in health insurance has evolved, most notably since President Barack Obama signed the Affordable Care Act in 2010, introducing expanded coverage protections and assistance for low-income Americans.
Tolbert said President Donald Trump did not make these things a priority during his time in office. He indicated he was open While President Trump has warned he would cut federal aid programs if re-elected, the Biden administration has adopted policies that make it easier for low-income Americans to get and keep health insurance.
The issue of CHIP premiums in this debate isn’t abstract to Erin Booth, a Florida mother. She said: Public Comments to Federal Regulators Regarding Florida’s proposed CHIP expansion, she said she would have to pay high premiums and copays for doctor’s visits to keep her 8-year-old son covered.
“I am faced with a difficult decision: pay my mortgage or pay my son’s health insurance,” she wrote.
KFF Health News a national newsroom producing in-depth journalism on health issues, is one of KFF’s core operating programs.
