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A bill to be entitled 1
An act relating to Florida Kidcare program 2
eligibility; amending s. 409.8132, F.S.; conforming a 3
provision to changes made by the act; amending s. 4
409.814, F.S.; increasing the income eligibility 5
threshold for coverage under the Florida Kidcare 6
program; requiring an applicant seeking coverage under 7
the program to provide certain documentation if 8
eligibility cannot be verified using reliable data 9
sources; amending s. 409.816, F.S.; requiring that 10
premiums for certain enrollees under the program be 11
based on a tiered system of uniform premiums; amending 12
s. 624.91, F.S.; conforming a provision to changes 13
made by the act; providing effective dates. 14
15
WHEREAS, as families progress up the economic ladder they 16
are adversely affected by the fiscal cliff, disincentivizing 17
upward mobility, and 18
WHEREAS, some of these families have lost access to Florida 19
Healthy Kids, which subsidizes children's health insurance, 20
creating a health care coverage gap, and 21
WHEREAS, the Legislature seeks to remove these barriers and 22
intends to facilitate a glide path for families to achieve 23
economic self-sufficiency and access the necessary health care 24
services for their children, NOW, THEREFOR E, 25
HB 1181 2022
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Be It Enacted by the Legislature of the State of Florida: 27
28
Section 1. Paragraph (a) of subsection (6) of section 29
409.8132, Florida Statutes, is amended to read: 30
409.8132 Medikids program component. — 31
(6) ELIGIBILITY.— 32
(a) A child who has att ained the age of 1 year but who is 33
under the age of 5 years is eligible to enroll in the Medikids 34
program component of the Florida Kidcare program, if the child 35
is a member of a family that has a family income which exceeds 36
the Medicaid applicable income l evel as specified in s. 409.903, 37
but which is equal to or below 250 200 percent of the current 38
federal poverty level. In determining the eligibility of such a 39
child, an assets test is not required. A child who is eligible 40
for Medikids may elect to enroll i n Florida Healthy Kids 41
coverage or employer -sponsored group coverage. However, a child 42
who is eligible for Medikids may participate in the Florida 43
Healthy Kids program only if the child has a sibling 44
participating in the Florida Healthy Kids program and th e 45
child's county of residence permits such enrollment. 46
Section 2. Effective July 1, 2023, paragraph (a) of 47
subsection (6) of section 409.8132, Florida Statutes, as amended 48
by this act, is amended to read: 49
409.8132 Medikids program component. — 50
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(6) ELIGIBILITY.— 51
(a) A child who has attained the age of 1 year but who is 52
under the age of 5 years is eligible to enroll in the Medikids 53
program component of the Florida Kidcare program, if the child 54
is a member of a family that has a family income which ex ceeds 55
the Medicaid applicable income level as specified in s. 409.903, 56
but which is equal to or below 300 250 percent of the current 57
federal poverty level. In determining the eligibility of such a 58
child, an assets test is not required. A child who is eligi ble 59
for Medikids may elect to enroll in Florida Healthy Kids 60
coverage or employer -sponsored group coverage. However, a child 61
who is eligible for Medikids may participate in the Florida 62
Healthy Kids program only if the child has a sibling 63
participating in the Florida Healthy Kids program and the 64
child's county of residence permits such enrollment. 65
Section 3. Section 409.814, Florida Statutes, is amended 66
to read: 67
409.814 Eligibility. —A child who has not reached 19 years 68
of age whose family income is equal to or below 250 200 percent 69
of the federal poverty level is eligible for the Florida Kidcare 70
program as provided in this section. If an enrolled individual 71
is determined to be ineligible for coverage, he or she must be 72
immediately disenrolled from the respective Florida Kidcare 73
program component. 74
(1) A child who is eligible for Medicaid coverage under s. 75
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409.903 or s. 409.904 must be enrolled in Medicaid and is not 76
eligible to receive health benefits under any other health 77
benefits coverage authorized under the Florida Kidcare program. 78
(2) A child who is not eligible for Medicaid, but who is 79
eligible for the Florida Kidcare program, may obtain health 80
benefits coverage under any of the other components listed in s. 81
409.813 if such coverage is approved and available in the county 82
in which the child resides. 83
(3) A Title XXI-funded child who is eligible for the 84
Florida Kidcare program who is a child with special h ealth care 85
needs, as determined through a medical or behavioral screening 86
instrument, is eligible for health benefits coverage from and 87
shall be assigned to and may opt out of the Children's Medical 88
Services Network. 89
(4) The following children are not el igible to receive 90
Title XXI-funded premium assistance for health benefits coverage 91
under the Florida Kidcare program, except under Medicaid if the 92
child would have been eligible for Medicaid under s. 409.903 or 93
s. 409.904 as of June 1, 1997: 94
(a) A child who is covered under a family member's group 95
health benefit plan or under other private or employer health 96
insurance coverage, if the cost of the child's participation is 97
not greater than 5 percent of the family's income. If a child is 98
otherwise eligible f or a subsidy under the Florida Kidcare 99
program and the cost of the child's participation in the family 100
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member's health insurance benefit plan is greater than 5 percent 101
of the family's income, the child may enroll in the appropriate 102
subsidized Kidcare progr am. 103
(b) A child who is seeking premium assistance for the 104
Florida Kidcare program through employer -sponsored group 105
coverage, if the child has been covered by the same employer's 106
group coverage during the 60 days before the family submitted an 107
application for determination of eligibility under the program. 108
(c) A child who is an alien but who does not meet the 109
definition of a lawfully residing child. This paragraph does not 110
extend eligibility for the Florida Kidcare program to an 111
undocumented immigrant. 112
(d) A child who is an inmate of a public institution or a 113
patient in an institution for mental diseases. 114
(e) A child who is otherwise eligible for premium 115
assistance for the Florida Kidcare program and has had his or 116
her coverage in an employer -sponsored or private health benefit 117
plan voluntarily canceled in the last 60 days, except those 118
children whose coverage was voluntarily canceled for good cause, 119
including, but not limited to, the following circumstances: 120
1. The cost of participation in an employ er-sponsored 121
health benefit plan is greater than 5 percent of the family's 122
income; 123
2. The parent lost a job that provided an employer -124
sponsored health benefit plan for children; 125
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3. The parent who had health benefits coverage for the 126
child is deceased; 127
4. The child has a medical condition that, without medical 128
care, would cause serious disability, loss of function, or 129
death; 130
5. The employer of the parent canceled health benefits 131
coverage for children; 132
6. The child's health benefits coverage ended b ecause the 133
child reached the maximum lifetime coverage amount; 134
7. The child has exhausted coverage under a COBRA 135
continuation provision; 136
8. The health benefits coverage does not cover the child's 137
health care needs; or 138
9. Domestic violence led to loss of coverage. 139
(5) A child who is otherwise eligible for the Florida 140
Kidcare program and who has a preexisting condition that 141
prevents coverage under another insurance plan as described in 142
paragraph (4)(a) which would have disqualified the child for the 143
Florida Kidcare program if the child were able to enroll in the 144
plan is eligible for Florida Kidcare coverage when enrollment is 145
possible. 146
(6) A child whose family income is above 250 200 percent 147
of the federal poverty level or a child who is excluded und er 148
the provisions of subsection (4) may participate in the Florida 149
Kidcare program as provided in s. 409.8132 or, if the child is 150
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ineligible for Medikids by reason of age, in the Florida Healthy 151
Kids program, subject to the following: 152
(a) The family is n ot eligible for premium assistance 153
payments and must pay the full cost of the premium, including 154
any administrative costs. 155
(b) The board of directors of the Florida Healthy Kids 156
Corporation may offer a reduced benefit package to these 157
children in order to limit program costs for such families. 158
(7) Once a child is enrolled in the Florida Kidcare 159
program, the child is eligible for coverage for 12 months 160
without a redetermination or reverification of eligibility, if 161
the family continues to pay the applicab le premium. Eligibility 162
for program components funded through Title XXI of the Social 163
Security Act terminates when a child attains the age of 19. A 164
child who has not attained the age of 5 and who has been 165
determined eligible for the Medicaid program is eli gible for 166
coverage for 12 months without a redetermination or 167
reverification of eligibility. 168
(8) When determining or reviewing a child's eligibility 169
under the Florida Kidcare program, the applicant shall be 170
provided with reasonable notice of changes in e ligibility which 171
may affect enrollment in one or more of the program components. 172
If a transition from one program component to another is 173
authorized, there shall be cooperation between the program 174
components and the affected family which promotes continuit y of 175
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health care coverage. Any authorized transfers must be managed 176
within the program's overall appropriated or authorized levels 177
of funding. Each component of the program shall establish a 178
reserve to ensure that transfers between components will be 179
accomplished within current year appropriations. These reserves 180
shall be reviewed by each convening of the Social Services 181
Estimating Conference to determine the adequacy of such reserves 182
to meet actual experience. 183
(9) In determining the eligibility of a chil d, an assets 184
test is not required. If eligibility for the Florida Kidcare 185
program cannot be verified using reliable data sources in 186
accordance with federal requirements, each applicant shall 187
provide documentation during the application process and the 188
redetermination process, including, but not limited to, the 189
following: 190
(a) Proof of family income, which must be verified 191
electronically to determine financial eligibility for the 192
Florida Kidcare program. Written documentation, which may 193
include wages and ea rnings statements or pay stubs, W -2 forms, 194
or a copy of the applicant's most recent federal income tax 195
return, is required only if the electronic verification is not 196
available or does not substantiate the applicant's income. 197
(b) A statement from all appl icable, employed family 198
members that: 199
1. Their employers do not sponsor health benefit plans for 200
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employees; 201
2. The potential enrollee is not covered by an employer -202
sponsored health benefit plan; or 203
3. The potential enrollee is covered by an employer-204
sponsored health benefit plan and the cost of the employer -205
sponsored health benefit plan is more than 5 percent of the 206
family's income. 207
(c) To enroll in the Children's Medical Services Network, 208
a completed application, including a clinical scree ning. 209
(10) Subject to paragraph (4)(a), the Florida Kidcare 210
program shall withhold benefits from an enrollee if the program 211
obtains evidence that the enrollee is no longer eligible, 212
submitted incorrect or fraudulent information in order to 213
establish eligibility, or failed to provide verification of 214
eligibility. The applicant or enrollee shall be notified that 215
because of such evidence program benefits will be withheld 216
unless the applicant or enrollee contacts a designated 217
representative of the program by a specified date, which must be 218
within 10 working days after the date of notice, to discuss and 219
resolve the matter. The program shall make every effort to 220
resolve the matter within a timeframe that will not cause 221
benefits to be withheld from an eligible enr ollee. 222
(11) The following individuals may be subject to 223
prosecution in accordance with s. 414.39: 224
(a) An applicant obtaining or attempting to obtain 225
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benefits for a potential enrollee under the Florida Kidcare 226
program when the applicant knows or should have known the 227
potential enrollee does not qualify for the Florida Kidcare 228
program. 229
(b) An individual who assists an applicant in obtaining or 230
attempting to obtain benefits for a potential enrollee under the 231
Florida Kidcare program when the individual kn ows or should have 232
known the potential enrollee does not qualify for the Florida 233
Kidcare program. 234
Section 4. Effective July 1, 2023, section 409.814, 235
Florida Statutes, as amended by this act, is amended to read: 236
409.814 Eligibility. —A child who has not reached 19 years 237
of age whose family income is equal to or below 300 250 percent 238
of the federal poverty level is eligible for the Florida Kidcare 239
program as provided in this section. If an enrolled individual 240
is determined to be ineligible for coverage, he or she must be 241
immediately disenrolled from the respective Florida Kidcare 242
program component. 243
(1) A child who is eligible for Medicaid coverage under s. 244
409.903 or s. 409.904 must be enrolled in Medicaid and is not 245
eligible to receive health benefits under any other health 246
benefits coverage authorized under the Florida Kidcare program. 247
(2) A child who is not eligible for Medicaid, but who is 248
eligible for the Florida Kidcare program, may obtain health 249
benefits coverage under any of the other componen ts listed in s. 250
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409.813 if such coverage is approved and available in the county 251
in which the child resides. 252
(3) A Title XXI-funded child who is eligible for the 253
Florida Kidcare program who is a child with special health care 254
needs, as determined through a medical or behavioral screening 255
instrument, is eligible for health benefits coverage from and 256
shall be assigned to and may opt out of the Children's Medical 257
Services Network. 258
(4) The following children are not eligible to receive 259
Title XXI-funded premium assistance for health benefits coverage 260
under the Florida Kidcare program, except under Medicaid if the 261
child would have been eligible for Medicaid under s. 409.903 or 262
s. 409.904 as of June 1, 1997: 263
(a) A child who is covered under a family member's group 264
health benefit plan or under other private or employer health 265
insurance coverage, if the cost of the child's participation is 266
not greater than 5 percent of the family's income. If a child is 267
otherwise eligible for a subsidy under the Florida Kidcare 268
program and the cost of the child's participation in the family 269
member's health insurance benefit plan is greater than 5 percent 270
of the family's income, the child may enroll in the appropriate 271
subsidized Kidcare program. 272
(b) A child who is seeking premiu m assistance for the 273
Florida Kidcare program through employer -sponsored group 274
coverage, if the child has been covered by the same employer's 275
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group coverage during the 60 days before the family submitted an 276
application for determination of eligibility under the program. 277
(c) A child who is an alien but who does not meet the 278
definition of a lawfully residing child. This paragraph does not 279
extend eligibility for the Florida Kidcare program to an 280
undocumented immigrant. 281
(d) A child who is an inmate of a publ ic institution or a 282
patient in an institution for mental diseases. 283
(e) A child who is otherwise eligible for premium 284
assistance for the Florida Kidcare program and has had his or 285
her coverage in an employer -sponsored or private health benefit 286
plan voluntarily canceled in the last 60 days, except those 287
children whose coverage was voluntarily canceled for good cause, 288
including, but not limited to, the following circumstances: 289
1. The cost of participation in an employer -sponsored 290
health benefit plan is gre ater than 5 percent of the family's 291
income; 292
2. The parent lost a job that provided an employer -293
sponsored health benefit plan for children; 294
3. The parent who had health benefits coverage for the 295
child is deceased; 296
4. The child has a medical condition that, without medical 297
care, would cause serious disability, loss of function, or 298
death; 299
5. The employer of the parent canceled health benefits 300
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coverage for children; 301
6. The child's health benefits coverage ended because the 302
child reached the maximum li fetime coverage amount; 303
7. The child has exhausted coverage under a COBRA 304
continuation provision; 305
8. The health benefits coverage does not cover the child's 306
health care needs; or 307
9. Domestic violence led to loss of coverage. 308
(5) A child who is othe rwise eligible for the Florida 309
Kidcare program and who has a preexisting condition that 310
prevents coverage under another insurance plan as described in 311
paragraph (4)(a) which would have disqualified the child for the 312
Florida Kidcare program if the child wer e able to enroll in the 313
plan is eligible for Florida Kidcare coverage when enrollment is 314
possible. 315
(6) A child whose family income is above 300 250 percent 316
of the federal poverty level or a child who is excluded under 317
the provisions of subsection (4) may participate in the Florida 318
Kidcare program as provided in s. 409.8132 or, if the child is 319
ineligible for Medikids by reason of age, in the Florida H ealthy 320
Kids program, subject to the following: 321
(a) The family is not eligible for premium assistance 322
payments and must pay the full cost of the premium, including 323
any administrative costs. 324
(b) The board of directors of the Florida Healthy Kids 325
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Corporation may offer a reduced benefit package to these 326
children in order to limit program costs for such families. 327
(7) Once a child is enrolled in the Florida Kidcare 328
program, the child is eligible for coverage for 12 months 329
without a redetermination or reveri fication of eligibility, if 330
the family continues to pay the applicable premium. Eligibility 331
for program components funded through Title XXI of the Social 332
Security Act terminates when a child attains the age of 19. A 333
child who has not attained the age of 5 and who has been 334
determined eligible for the Medicaid program is eligible for 335
coverage for 12 months without a redetermination or 336
reverification of eligibility. 337
(8) When determining or reviewing a child's eligibility 338
under the Florida Kidcare program, th e applicant shall be 339
provided with reasonable notice of changes in eligibility which 340
may affect enrollment in one or more of the program components. 341
If a transition from one program component to another is 342
authorized, there shall be cooperation between the program 343
components and the affected family which promotes continuity of 344
health care coverage. Any authorized transfers must be managed 345
within the program's overall appropriated or authorized levels 346
of funding. Each component of the program shall establish a 347
reserve to ensure that transfers between components will be 348
accomplished within current year appropriations. These reserves 349
shall be reviewed by each convening of the Social Services 350
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Estimating Conference to determine the adequacy of such reserves 351
to meet actual experience. 352
(9) In determining the eligibility of a child, an assets 353
test is not required. If eligibility for the Florida Kidcare 354
program cannot be verified using reliable data sources in 355
accordance with federal requirements, each applicant sha ll 356
provide documentation during the application process and the 357
redetermination process, including, but not limited to, the 358
following: 359
(a) Proof of family income, which must be verified 360
electronically to determine financial eligibility for the 361
Florida Kidcare program. Written documentation, which may 362
include wages and earnings statements or pay stubs, W -2 forms, 363
or a copy of the applicant's most recent federal income tax 364
return, is required only if the electronic verification is not 365
available or does not substantiate the applicant's income. 366
(b) A statement from all applicable, employed family 367
members that: 368
1. Their employers do not sponsor health benefit plans for 369
employees; 370
2. The potential enrollee is not covered by an employer -371
sponsored health ben efit plan; or 372
3. The potential enrollee is covered by an employer -373
sponsored health benefit plan and the cost of the employer -374
sponsored health benefit plan is more than 5 percent of the 375
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family's income. 376
(c) To enroll in the Children's Medical Services N etwork, 377
a completed application, including a clinical screening. 378
(10) Subject to paragraph (4)(a), the Florida Kidcare 379
program shall withhold benefits from an enrollee if the program 380
obtains evidence that the enrollee is no longer eligible, 381
submitted incorrect or fraudulent information in order to 382
establish eligibility, or failed to provide verification of 383
eligibility. The applicant or enrollee shall be notified that 384
because of such evidence program benefits will be withheld 385
unless the applicant or enroll ee contacts a designated 386
representative of the program by a specified date, which must be 387
within 10 working days after the date of notice, to discuss and 388
resolve the matter. The program shall make every effort to 389
resolve the matter within a timeframe that will not cause 390
benefits to be withheld from an eligible enrollee. 391
(11) The following individuals may be subject to 392
prosecution in accordance with s. 414.39: 393
(a) An applicant obtaining or attempting to obtain 394
benefits for a potential enrollee under the Florida Kidcare 395
program when the applicant knows or should have known the 396
potential enrollee does not qualify for the Florida Kidcare 397
program. 398
(b) An individual who assists an applicant in obtaining or 399
attempting to obtain benefits for a potential enroll ee under the 400
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Florida Kidcare program when the individual knows or should have 401
known the potential enrollee does not qualify for the Florida 402
Kidcare program. 403
Section 5. Subsection (3) of section 409.816, Florida 404
Statutes, is amended to read: 405
409.816 Limitations on premiums and cost sharing. —The 406
following limitations on premiums and cost sharing are 407
established for the program. 408
(3) Enrollees in families with a family income above 150 409
percent of the federal poverty level who are not receiving 410
coverage under the Medicaid program or who are not eligible 411
under s. 409.814(6) may be required to pay enrollment fees, 412
premiums, copayments, deductibles, coinsurance, or similar 413
charges on a sliding scale related to income, except that the 414
total annual aggregate c ost sharing with respect to all children 415
in a family may not exceed 5 percent of the family's income. 416
However, copayments, deductibles, coinsurance, or similar 417
charges may not be imposed for preventive services, including 418
well-baby and well-child care, age-appropriate immunizations, 419
and routine hearing and vision screenings. Premiums for 420
enrollees paying enrollment fees, premiums, copayments, 421
deductibles, coinsurance, or similar charges as provided in this 422
subsection shall be based on at least three but no more than 423
five tiers of uniform premiums that increase with each tier as a 424
percentage of the applicable threshold amount of the federal 425
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poverty level, by tier. 426
Section 6. Paragraph (b) of subsection (2) of section 427
624.91, Florida Statutes, is amended t o read: 428
624.91 The Florida Healthy Kids Corporation Act. — 429
(2) LEGISLATIVE INTENT. — 430
(b) It is the intent of the Legislature that the Florida 431
Healthy Kids Corporation serve as one of several providers of 432
services to children eligible for medical assist ance under Title 433
XXI of the Social Security Act. Although the corporation may 434
serve other children, the Legislature intends the primary 435
recipients of services provided through the corporation be 436
school-age children with a family income equal to or below 250 437
200 percent of the federal poverty level, who do not qualify for 438
Medicaid. It is also the intent of the Legislature that state 439
and local government Florida Healthy Kids funds be used to 440
continue coverage, subject to specific appropriations in the 441
General Appropriations Act, to children not eligible for federal 442
matching funds under Title XXI. 443
Section 7. Effective July 1, 2023, paragraph (b) of 444
subsection (2) of section 624.91, Florida Statutes, as amended 445
by this act, is amended to read: 446
624.91 The Florida Healthy Kids Corporation Act. — 447
(2) LEGISLATIVE INTENT. — 448
(b) It is the intent of the Legislature that the Florida 449
Healthy Kids Corporation serve as one of several providers of 450
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services to children eligible for medical assistance under Title 451
XXI of the Social Security Act. Although the corporation may 452
serve other children, the Legislature intends the primary 453
recipients of services provided through the corporation be 454
school-age children with a family income equal to or below 300 455
250 percent of the federal poverty level, who do not qualify for 456
Medicaid. It is also the intent of the Legislature that state 457
and local government Florida Healthy Kids funds be used to 458
continue coverage, subject to specific appropriations in the 459
General Appropriations Act, t o children not eligible for federal 460
matching funds under Title XXI. 461
Section 8. Except as otherwise expressly provided in this 462
act, this act shall take effect July 1, 2022. 463