EDITORIAL: State’s health care cuts hurt children

Feb. 26--Does the state government care enough about what happens to Florida's poor, sick and disabled children?

Based on the available evidence, the answer is no.

About 9.6 percent of children in Florida lacked health insurance in 2014, according to a study released last week by the Robert Wood Johnson Foundation. That's the fifth-highest rate of uninsured children for any state -- an estimated 413,000 children.

And those numbers are down significantly from 2013, when Florida's rate was 11.7 percent. The study's authors credited that drop to the Affordable Care Act, which began generating low-cost coverage in 2014.

Children of families that purchased policies through the ACA benefited from that coverage, plus the federal law's outreach efforts provided poor families with information on state-run insurance programs for children.

Even more children would have had at least some insurance if Gov. Rick Scott and the Florida Legislature had agreed to expand Medicaid eligibility as called for under the ACA.

Scott and legislative leaders said the state can't afford its minimal share of that expansion (the federal government would pay at least 90 percent of the cost), though now they're pondering how to provide $1 billion in tax cuts -- mostly to benefit businesses.

As for those state-run insurance programs for children, the Scott administration is working hard to cut their costs, eliminate benefits and reduce eligibility.

The administration isn't deterred by a federal judge's ruling in December 2014 that Florida's Medicaid program left the 2 million children enrolled in it "with a second-rate health care system so poorly funded it violates federal law," as the Miami Herald reported.

That case still is in litigation, but the state has moved forward with a policy designed to reduce access to its Children's Medical Services program, which provides care for children with serious and chronic conditions such as severe vision and hearing impairments, facial deformities and metabolic disorders.

The reductions were brought about through a revised eligibility-screening process instituted last May by the state Department of Health, which oversees CMS.

Florida Surgeon General John Armstrong told a children's advocacy group last month that 13,074 of approximately 71,000 children served by CMS had "transitioned" out of the program in 2015 because they failed to meet the new eligibility criteria.

Armstrong said the Department of Health had worked with the families of those children to ensure they received the same standard of care in Medicaid managed-care programs.

Those would be the same Medicaid programs that the federal judge called "a second-rate health care system."

"This is definitely rationing of care," Phyllis Soyer, a CMS administrator from 1979 to 2011, told the Miami Herald. Medicaid doesn't do what CMS does, she said, such as providing care coordinators to help families obtain therapy and medication.

"If somebody were to swear on a stack of Bibles that (Medicaid) could meet the needs of these children, I'd say 'fine,' "Soyer noted. "But I don't believe it."

The state's actions regarding CMS and Medicaid were factors in a confirmation hearing for Armstrong held Tuesday before the Florida Senate's Health Policy Committee. Armstrong was appointed by Scott in 2012 and reappointed in 2014 but is yet to be confirmed by the Senate for his second term.

Despite some legislators' pointed criticism of Armstrong's and Scott's policies, the committee voted 5-4 in favor of confirmation.

If the committee had rejected Armstrong, it could have sent a message to Scott that his administration's penchant for cutting funds for children's health care is simply not acceptable.

But, with $1 billion in tax cuts on the table, who cares about a couple million poor, sick and disabled children?

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