Children without health insurance on rise in Volusia, Flagler and Florida

Feb. 25-- Feb. 25--When Kristina Marty moved to Daytona Beach in 2017 from Rhode Island, she had no idea her decision would cost her four children their free health insurance.

"They were on the Rhode Island state insurance, I was making $52,000 a year and they still qualified for the state insurance, so it was just fees for me," Marty said. "When I moved here I was on Rhode Island unemployment which was $522 a week and they (her children) didn't even qualify for Florida KidCare insurance."

Under Florida KidCare, children are assigned into one of a number of health-care programs based on their ages and income levels. Some of those programs require monthly premiums and co-payments.

Adding the children to her insurance plan at work would cost Marty close to $800 a month. Because of such a high cost and the unavailability of state insurance, Marty made the decision to leave her children uninsured, a growing trend in Florida despite an improving economy.

The Georgetown University Center for Children and Families in November issued a report that showed about 325,000 uninsured children in Florida in 2017, up from 288,000 in 2016. The numbers means Florida ranks as the second-highest state for uninsured children.

Florida's overall uninsured rate for children is at 7.3 percent while the national average sits at 5 percent. But the number of uninsured children nationally also increased from 3.649 million in 2016 to 3.925 million last year, the first time in nearly a decade the numbers have increased, according to the report.

In Volusia County 6.3 percent of children are uninsured; in Flagler County 8.7 percent of children are uninsured, according to data linked to the report.

"With an improving economy and low unemployment rate, the fact our nation is going backwards on children's health coverage is very troubling," said Joan Alker, who serves as executive director of the Georgetown center and is the lead author of the report. "Even states with the best of intentions were unable to withstand strong national currents to fully protect children from losing coverage."

Alker attributed the increase in uninsured children to a variety of factors, including uncertainty about the federal Affordable Care Act (ACA) and slashing public funding for "navigators" who help people obtain health coverage. Another potential factor is a rule proposed by the administration of President Donald Trump that would make it more difficult for legally residing immigrants to get green cards if they tap into benefits such as Medicaid, which was not expanded under the ACA.

Alker said the best thing a state can do to address the increases in uninsured children is to expand Medicaid.

For Kait York, mother of a 7-year-old in Southeast Volusia County, adding her daughter onto her work's health insurance meant losing half of each paycheck. Combined, York and her wife make $40,000 a year.

"We looked into putting her on both mine and my wife's employers, Florida Healthy Kids, Florida KidCare and and through different options on marketplace," said York. "Any of the ones that were even remotely affordable had a huge deduction and it made absolutely no sense to even get it."

For children without insurance, there is a glimmer of hope in the distance. Florida may have a plan to address the increasing number of children who lack health insurance, but it remains to be seen whether the proposal will receive funding.

The state Agency for Health Care Administration wants $16.3 million to help insure an additional 22,000 children in the Florida Healthy Kids program -- also known as Florida KidCare -- and lower the costs for some children already in the program, according to a legislative budget request.

Florida Healthy Kids Chief Executive Officer Rebecca Matthews said the moves would lower premiums to $170 a month for so-called full-pay children, which could attract more children to the program. The current cost is $215 per month.

"Through a proposed legislative budget request, we hope to reduce the cost of our full-pay program and offer Florida families a more affordable solution to covering their kids," said Florida Healthy Kids Board Chair Stephanie Haridopolos. "With lower monthly premiums, no deductibles and low co-pays, I know it will be an attractive addition to the insurance market."

York said if the price dropped that much she could enroll her children in the program.

"Right now we have to pick and choose whose medical issues are more urgent to take care of at the moment," York said. "I don't have insurance either and I have medical issues that need to be addressed every couple of months. Having that plan would help a lot."

But state House of Representatives Speaker Jose Oliva is frustrated by the amount of money taxpayers already spend on health care and has made lowering costs a top priority. While he says he's troubled by the rise in the uninsured rates, he may nevertheless be hesitant to approve increased funding.

"To say 'I'm troubled by it, I'll dump a whole bunch more money in it,' is to say, 'The next presiding officers will then have to come back and try to figure it out because the prices will continue to rise,' " Oliva told The News Service of Florida last month.

Anne Swerlick, a health analyst and attorney for the Florida Policy Institute, said the Georgetown University Center for Children and Families report's findings are disturbing and worries that the numbers of children without insurance may continue to rise.

"I don't think there's any political debate that having health coverage for kids is a good thing," Swerlick said, adding that Florida has been "doing a great job" of getting more children insured over the years.

In 2008, the percentage of children in Florida without insurance was 17.3 percent.

"There's been a lot of hard work out in the community, so now that the trend line is creeping back up, I think we really need to take a hard look at why that's happening and have a strategy and action to push back on that," Swerlick said.

Medicaid continues to be the primary source of health coverage for the children who are insured in Florida. The data shows that Medicaid and the Children's Health Insurance Program were the primary sources of coverage in 2017, insuring nearly 40 percent of the children who have coverage. Another 38 percent of the insured children in 2017 had coverage through health plans offered by employers.

The Georgetown University Center for Children and Families report also indicated the percentage of children in Florida without insurance went up across the six different racial and ethnicity categories as well in five different income brackets.

The largest jump was in the percentage of uninsured white children. In 2016, 6.4 percent of white children were uninsured. That figure jumped to 7.2 percent in 2017. Moreover, it was children living in families who earned between 200 percent and 299 percent of the federal poverty level (or between $48,600 and $72,900 for a family of four) with the biggest increase in uninsured rates.

The study used data from the 2017 American Community Survey published by the U.S. Census Bureau.

Florida law requires most Medicaid patients to confirm twice a year that they still meet income requirements to qualify for the program, except for children under age 5 who have annual eligibility. Some advocates fear that children are falling off the Medicaid rolls during the re-qualifying process.

Florida has worked with Medicaid managed-care plans to provide coverage for beneficiaries since 2013, after the Legislature passed an overhaul of the Medicaid program.

News Service of Florida's Christine Sexton contributed to this report.

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