OP ED       We Can't Stay Quiet

I've been reading with interest the articles relaying the Agency for Health Care Administration’s  Secretary Alan Levine's concern about the 3,600 children who are at risk of losing their health insurance due to budget cuts in Miami-Dade County. This is referring to the local match required to draw down state dollars to assist with coverage for those children who are not eligible for federal matching dollars.

Once again policy makers are being penny-wise and pound-foolish as Miami-Dade will lose more than they will "save" should they not provide the money  needed to keep these kids insured.  I trust that they will find the means necessary to continue coverage.

Of particular interest were the following statements made by Secretary Levine: "We understand the problems Jackson Memorial Hospital is having, but it's difficult for us to stay quiet when we learn that 3,600 children are going to be dropped from the insurance rolls," Levine said. "This is a huge step backward." And later on..."I don't care what their source is, I just think it would be a travesty if Mayor Penelas allowed these children to be uninsured," Levine said. "Mayor Penelas has the opportunity to put his money where his mouth is and I know he'll do the right thing."

While it would be a travesty for Miami-Dade County to let 3,600 children lose their health insurance Secretary Levine and the Governor in conjunction with the Florida Healthy Kids Corporation have been watching quietly as close to 6,600 children a month have been losing their Medicaid coverage because of a change in age or family income. Internal policy decisions made by Secretary Levine's agency, the Governor and Florida Healthy Kids Board have not allowed these children to transfer into another KidCare program for which they are eligible -- BECAUSE THERE IS A FREEZE ON ENROLLMENT. The law says that children who are already enrolled in the KidCare program can transfer as long as there is funding available. Money was appropriated for approximately 116,000 children on the waiting list last Session and far less than half of them have been enrolled.

Healthy Kids 2004 annual report has an entire section entitled "Florida KidCare: Four in One" in which it states that "Medikids, Healthy Kids, Children's Medical Services Network (CMSN) and Medicaid make up Florida KidCare. All four of the KidCare programs share one focus and goal: providing comprehensive, high-quality health care coverage for Florida's uninsured children."

SO WHY ARE MEDICAID TRANSFER CHILDREN BEING LEFT OUTSIDE OF THE SO-CALLED SEAMLESS SYSTEM?? Since May 2004 a number of groups and individuals including the KidCare Coordinating Council, the Florida Pediatric Society, and 14 Democratic House Members have called upon the Healthy Kids Board and Secretary Levine's Agency for Health Care Administration to include Medicaid children in the transfer policy. The call has been for retroactive and prospective inclusion. Only recently was a decision made to include some of the children who lose their Medicaid coverage due to over-income changes.  The policy will only apply to children who lost their coverage starting in July 2004. They will be allowed to APPLY for KidCare. They will have to fill out the newly required volumes of paperwork even though the Department of Children and Families just did the numbers to determine that they were no longer eligible for Medicaid.

Is this what they mean by administrative efficiency, paying Healthy Kids to duplicate the Department of Children and Families income verification checks?

According to figures provided by Healthy Kids approximately 6,600 children lose their Medicaid coverage every month due to over-income which means from March to June more than 26,000 children LOST THEIR HEALTH INSURANCE BECAUSE THE GOVERNOR AND THE AGENCIES IN CHARGE  DECIDED NOT TO COVER THEM - 26,000 children.

"...but it's difficult for us to stay quiet when we learn that 3,600 children are going to be dropped from the insurance rolls," Levine said.

In addition to the Medicaid transfer policy the same groups have been calling upon Secretary Levine, the Governor and the Healthy Kids Corporation to remove the punitive policy that requires children to lose their health insurance for half a year if their parents are late (even by a day or two) with their premium payments. THE LAW SAYS THAT COVERAGE SHALL BE DENIED FOR AT LEAST 60 DAYS -- in order to save money the policy was changed to 6 months.

According to a document presented by the Healthy Kids Corporation at the June Healthy Kids Board meeting  anywhere from a low of 1,900 to a high of 7,400 with an average of 4,400 children a month are without coverage because of the policy decision made by Healthy Kids, the Agency for Health Care Administration and the Governor's office. These are kids that are in the program they are just doing without for half a year because their parents were late with their payment.

According to Kenney Shipley (representing CFO Tom Gallagher), the Chair of the Healthy Kids Board, Secretary Levine, et al. are not sitting quietly by on this one either. Their response to the Legislators request to repeal this policy as stated in a letter sent July 13, 2004 is:  "When all of the Florida KidCare partners met to find ways to address the budget shortfall prior to the 2004 session, the partners agreed that the waiting period for children whose coverage lapsed for failure to pay the premium would be 6 months. With the additional cost of covering children moving from Medicaid, all of the KidCare partners would need to jointly analyze the fiscal impact and determine whether this change should be continued or revised."....

The projected "savings" by the way is a little over $2 million. The state is losing $4.6 million in federal dollars while saving the $2 million in general revenue.

Perhaps we should thank Miami-Dade County for focusing attention on 3,600 children in danger of losing their health insurance -- THE 30,000 CHILDREN WHO HAVE ALREADY LOST THEIRS OVER THE PAST 6 MONTHS APPRECIATE THE RHETORICAL SUPPORT THEY HAVE ENGENDERED.

It is equally important that Secretary Levine, Governor Bush, Mayor Penelas and the Florida Legislature join together to make the rhetoric a reality not only for the aforementioned  children who have already lost or are about to lose their health insurance,  but for the 500,000 uninsured children throughout Florida who are waiting for some unknown open enrollment period with the hope of securing coverage.  We respectfully request that you put OUR money where your mouths are.

Just think of the political football you could play by teaming up to provide quality health insurance to all of Florida’s children, regardless of their national origin or immigration status, regardless of their political affiliation and regardless of their income.  Wouldn’t that make a fine national press release just prior to the November elections?

Karen Woodall is a political consultant based in Tallahassee.  She has been working on children’s issues for 24 years.  She is a member of the KidCare Coordinating Council.
Woodall can be reached at kbwtally@aol.com