February 2, 2024

Statement on Florida’s Lawsuit Against CMS

On Feb. 1, 2024, the state Agency for Health Care Administration filed a lawsuit against the federal Centers for Medicare and Medicaid Services and Department of Health and Human Services, claiming that a new requirement “unlawfully undermines” the recent expansion of Florida’s Children’s Health Insurance Program (CHIP).

In 2023, the Florida Legislature passed legislation (
HB 121) that increases the household income threshold for KidCare — the state’s CHIP — from 200 to 300 percent of the Federal Poverty Level (FPL), which will enable an estimated 42,000 kids to get coverage with lower premiums. While new payment tiers for the program were slated to take effect on Jan. 1, 2024, a misinterpretation of federal procedures delayed implementation, which is now scheduled for April 2024.

A new federal law took effect on January 1, 2024, that requires states to provide 12 months of continuous eligibility to children under 19 who are enrolled in Medicaid and CHIP, with no exceptions. In October 2023, CMS
clarified via rule that non-payment of premiums is not an exception to the new continuous eligibility law. Florida contests this new rule in its lawsuit.

Florida Policy Institute (FPI) released the statement below regarding the lawsuit.

In 2023 the Florida Legislature — by unanimous votes in both the House and Senate — approved a measure to increase children’s access to health care coverage by expanding the state’s KidCare program.

After the important leap forward that state leaders took in prioritizing children’s health, this new lawsuit against CMS is a big step backward. Seeking to undermine the new continuous eligibility requirement would jeopardize the health and wellness of Florida children.

Families in Florida are already facing a delay in implementing the KidCare expansion, and this lawsuit will only add to the delay. Furthermore, this misguided action is coming on the heels of the Medicaid redetermination process, during which 515,873 children in Florida have lost coverage. According to the state’s Medicaid redetermination plan, the final phase of this process (through March) will focus on eligibility of medically fragile children — those with illnesses like cancer and cerebral palsy. This lawsuit could have grave and life-threatening consequences as families between 200 and 300 percent of the federal poverty level will be unable to seamlessly transition to KidCare.

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