DeSantis administration gets pushback for its child health policies

The DeSantis administration has not expanded Florida families' access to a low-cost health insurance plan for children despite a 2023 law requiring it to do so. (Getty Images)

The DeSantis administration is getting pushback for its children's health care policies and its decision to remove tens of thousands of children from a subsidized health insurance program.

During a Joint Legislative Budget Commission meeting held Friday, Medicaid Director Brian Meyer said enrollment in the Florida KidCare program was lower than what the state's top economists had predicted. That led to a recommendation to sweep $32 million from the program and redirect it to the state's general revenue fund.

The legislative panel, authorized to make spending decisions while the Legislature is not in session, voted to sweep the money from the low-cost health insurance program but the vote wasn't unanimous and it followed concerns raised by a bipartisan group of legislators.

Lori Berman (Photo via Florida Senate)

"I'm really disappointed, and I'd like to see [the Agency for Health Care Administration] actually help the people of the state of Florida who are struggling with having to insure their children, to give their children health insurance. And I find this whole thing very troubling," said Sen. Lori Berman, a Democrat from Boca Raton who opposed the $32 million sweep.

Specifically, Meyer was asked about the DeSantis administration's decision to defy a federal law that requires the state to keep children enrolled for up to 12 months in the federal children's health insurance program, which operates in the state under the Florida KidCare moniker, even if their parents don't pay monthly premiums, which range between $15 and $20 a month.

The DeSantis administration challenged the policy in federal court, arguing the continuous eligibility requirement runs afoul of a state law requiring families to contribute to the costs of coverage and, moreover, that the premiums are a vital financing component for the program. And it disenrolled tens of thousands of children whose families didn't pay premiums.

While the state dropped its legal challenge in February, Meyer said conversations between the state and the Centers for Medicare and Medicaid Services (CMS) over the policy continue.

"As recently as last week, I've had conversations with CMS about this, so we are actively trying to get to an agreeable place between both parties so we can move this program," Meyer said.

When Berman asked whether the state continues to disenroll children, Meyer said, "I believe that is the case."

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Florida KidCare is an optional Medicaid expansion for children whose families earn too much to qualify for the traditional Medicaid program. It is the state's version of the federal children's health insurance program (CHIP), passed by Congress in 1997.

The federal government pays about 69 cents of every dollar. The rest is funded through a combination of state funds and family premiums.

The dispute between the DeSantis administration and the federal government over the continuous eligibility requirement goes beyond whether children should remain eligible for coverage when premiums aren't paid.

AHCA Deputy Secretary for Medicaid Brian Meyer (via LinkedIn)

It has also prevented the state from moving ahead with implementing a 2023 law championed by former House Speaker and Republican gubernatorial hopeful Paul Renner. Passed unanimously by the Florida Legislature, HB 121 boosted the maximum qualifying family income from 200% to 300% of the federal poverty level.

In 2026, that's the difference between earning $66,000 annually for a family of four versus $99,000 annually. An estimated 42,000 uninsured children were estimated to benefit from the change.

The state needed approval from CMS to increase the income limit, which it received in December 2024. But the approval came with the caveat that the state abide by the continuous eligibility requirements.

Stuart Republican Sen. Gayle Harrell voted Friday to sweep the surplus from KidCare, but said she wanted to know more about the administration's efforts to implement the 2023 law.

"I'd like very much to get further detail on where that is, and I think that is a significant issue that we need to address," she said.

Harrell's comments were echoed by Sen. Ed Hooper, R-Clearwater, the Senate budget chair. He told reporters following the meeting that "wouldn't it be lovely" if the DeSantis administration followed edicts from the Legislature.

He said agencies should remember to carry out the "wishes of the Legislature. He added that "KidCare is pretty darn important."

Courtesy of Florida Phoenix