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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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, THEREFO RE, 25
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
26
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 at tained 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 level 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 in 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 t he 45
child's county of residence permits such enrollment. 46
Section 2. Effective July 1, 2024, 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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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(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 e xceeds 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 elig ible 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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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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) A Title XXI-funded child who reac hes 19 years of age 90
is eligible for continued Title XXI -funded coverage for the 91
duration of a pregnancy and the postpartum period consisting of 92
the 12-month period beginning on the last day of a pregnancy, if 93
such pregnancy or postpartum period begins prio r to the child 94
reaching 19 years of age, and if the child is ineligible for 95
Medicaid. 96
(5) The following children are not eligible to receive 97
Title XXI-funded premium assistance for health benefits coverage 98
under the Florida Kidcare program, except under Medicaid if the 99
child would have been eligible for Medicaid under s. 409.903 or 100
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
s. 409.904 as of June 1, 1997: 101
(a) A child who is covered under a family member's group 102
health benefit plan or under other private or employer health 103
insurance coverage, if t he cost of the child's participation is 104
not greater than 5 percent of the family's income. If a child is 105
otherwise eligible for a subsidy under the Florida Kidcare 106
program and the cost of the child's participation in the family 107
member's health insurance be nefit plan is greater than 5 percent 108
of the family's income, the child may enroll in the appropriate 109
subsidized Kidcare program. 110
(b) A child who is seeking premium assistance for the 111
Florida Kidcare program through employer -sponsored group 112
coverage, if the child has been covered by the same employer's 113
group coverage during the 60 days before the family submitted an 114
application for determination of eligibility under the program. 115
(c) A child who is an alien but who does not meet the 116
definition of a lawful ly residing child. This paragraph does not 117
extend eligibility for the Florida Kidcare program to an 118
undocumented immigrant. 119
(d) A child who is an inmate of a public institution or a 120
patient in an institution for mental diseases. 121
(e) A child who is othe rwise eligible for premium 122
assistance for the Florida Kidcare program and has had his or 123
her coverage in an employer -sponsored or private health benefit 124
plan voluntarily canceled in the last 60 days, except those 125
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
children whose coverage was voluntarily can celed for good cause, 126
including, but not limited to, the following circumstances: 127
1. The cost of participation in an employer -sponsored 128
health benefit plan is greater than 5 percent of the family's 129
income; 130
2. The parent lost a job that provided an empl oyer-131
sponsored health benefit plan for children; 132
3. The parent who had health benefits coverage for the 133
child is deceased; 134
4. The child has a medical condition that, without medical 135
care, would cause serious disability, loss of function, or 136
death; 137
5. The employer of the parent canceled health benefits 138
coverage for children; 139
6. The child's health benefits coverage ended because the 140
child reached the maximum lifetime coverage amount; 141
7. The child has exhausted coverage under a COBRA 142
continuation provision; 143
8. The health benefits coverage does not cover the child's 144
health care needs; or 145
9. Domestic violence led to loss of coverage. 146
(6) A child who is otherwise eligible for the Florida 147
Kidcare program and who has a preexisting condition that 148
prevents coverage under another insurance plan as described in 149
paragraph (5)(a) which would have disqualified the child for the 150
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
Florida Kidcare program if the child were able to enroll in the 151
plan is eligible for Florida Kidcare coverage when enrollment is 152
possible. 153
(7) A child whose family income is above 250 200 percent 154
of the federal poverty level or a child who is excluded under 155
the provisions of subsection (5) may participate in the Florida 156
Kidcare program as provided in s. 409.8132 or, if the child is 157
ineligible for Medikids by reason of age, in the Florida Healthy 158
Kids program, subject to the following: 159
(a) The family is not eligible for premium assistance 160
payments and must pay the full cost of the premium, including 161
any administrative costs. 162
(b) The board of directors of the Florida Healthy Kids 163
Corporation may offer a reduced benefit package to these 164
children in order to limit program costs for such families. 165
(8) Once a child is enrolled in the Florida Kidcare 166
program, the child is eligible for c overage for 12 months 167
without a redetermination or reverification of eligibility, if 168
the family continues to pay the applicable premium. Eligibility 169
for program components funded through Title XXI of the Social 170
Security Act terminates when a child attains the age of 19. A 171
child who has not attained the age of 5 and who has been 172
determined eligible for the Medicaid program is eligible for 173
coverage for 12 months without a redetermination or 174
reverification of eligibility. 175
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(9) When determining or reviewing a child's eligibility 176
under the Florida Kidcare program, the applicant shall be 177
provided with reasonable notice of changes in eligibility which 178
may affect enrollment in one or more of the program components. 179
If a transition from one program component to anot her is 180
authorized, there shall be cooperation between the program 181
components and the affected family which promotes continuity of 182
health care coverage. Any authorized transfers must be managed 183
within the program's overall appropriated or authorized levels 184
of funding. Each component of the program shall establish a 185
reserve to ensure that transfers between components will be 186
accomplished within current year appropriations. These reserves 187
shall be reviewed by each convening of the Social Services 188
Estimating Conference to determine the adequacy of such reserves 189
to meet actual experience. 190
(10) In determining the eligibility of a child, an assets 191
test is not required. If eligibility for the Florida Kidcare 192
program cannot be verified using reliable data sources i n 193
accordance with federal requirements, each applicant shall 194
provide documentation during the application process and the 195
redetermination process, including, but not limited to, the 196
following: 197
(a) Proof of family income, which must be verified 198
electronically to determine financial eligibility for the 199
Florida Kidcare program. Written documentation, which may 200
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
include wages and earnings statements or pay stubs, W -2 forms, 201
or a copy of the applicant's most recent federal income tax 202
return, is required only if the electronic verification is not 203
available or does not substantiate the applicant's income. 204
(b) A statement from all applicable, employed family 205
members that: 206
1. Their employers do not sponsor health benefit plans for 207
employees; 208
2. The potential enrollee is not covered by an employer -209
sponsored health benefit plan; or 210
3. The potential enrollee is covered by an employer -211
sponsored health benefit plan and the cost of the employer -212
sponsored health benefit plan is more than 5 percent of the 213
family's income. 214
(c) To enroll in the Children's Medical Services Network, 215
a completed application, including a clinical screening. 216
(11) Subject to paragraph (5)(a), the Florida Kidcare 217
program shall withhold benefits from an enrollee if the program 218
obtains evidence that the enrollee is no longer eligible, 219
submitted incorrect or fraudulent information in order to 220
establish eligibility, or failed to provide verification of 221
eligibility. The applicant or enrollee shall be notified that 222
because of such evidence progr am benefits will be withheld 223
unless the applicant or enrollee contacts a designated 224
representative of the program by a specified date, which must be 225
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
within 10 working days after the date of notice, to discuss and 226
resolve the matter. The program shall make every effort to 227
resolve the matter within a timeframe that will not cause 228
benefits to be withheld from an eligible enrollee. 229
(12) The following individuals may be subject to 230
prosecution in accordance with s. 414.39: 231
(a) An applicant obtaining or attemp ting to obtain 232
benefits for a potential enrollee under the Florida Kidcare 233
program when the applicant knows or should have known the 234
potential enrollee does not qualify for the Florida Kidcare 235
program. 236
(b) An individual who assists an applicant in obtain ing or 237
attempting to obtain benefits for a potential enrollee under the 238
Florida Kidcare program when the individual knows or should have 239
known the potential enrollee does not qualify for the Florida 240
Kidcare program. 241
Section 4. Effective July 1, 2024, s ection 409.814, 242
Florida Statutes, as amended by this act, is amended to read: 243
409.814 Eligibility. —A child who has not reached 19 years 244
of age whose family income is equal to or below 300 250 percent 245
of the federal poverty level is eligible for the Flori da Kidcare 246
program as provided in this section. If an enrolled individual 247
is determined to be ineligible for coverage, he or she must be 248
immediately disenrolled from the respective Florida Kidcare 249
program component. 250
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(1) A child who is eligible for Medica id coverage under s. 251
409.903 or s. 409.904 must be enrolled in Medicaid and is not 252
eligible to receive health benefits under any other health 253
benefits coverage authorized under the Florida Kidcare program. 254
(2) A child who is not eligible for Medicaid, bu t who is 255
eligible for the Florida Kidcare program, may obtain health 256
benefits coverage under any of the other components listed in s. 257
409.813 if such coverage is approved and available in the county 258
in which the child resides. 259
(3) A Title XXI-funded child who is eligible for the 260
Florida Kidcare program who is a child with special health care 261
needs, as determined through a medical or behavioral screening 262
instrument, is eligible for health benefits coverage from and 263
shall be assigned to and may opt out of t he Children's Medical 264
Services Network. 265
(4) A Title XXI-funded child who reaches 19 years of age 266
is eligible for continued Title XXI -funded coverage for the 267
duration of a pregnancy and the postpartum period consisting of 268
the 12-month period beginning on the last day of a pregnancy, if 269
such pregnancy or postpartum period begins prior to the child 270
reaching 19 years of age, and if the child is ineligible for 271
Medicaid. 272
(5) The following children are not eligible to receive 273
Title XXI-funded premium assistanc e for health benefits coverage 274
under the Florida Kidcare program, except under Medicaid if the 275
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
child would have been eligible for Medicaid under s. 409.903 or 276
s. 409.904 as of June 1, 1997: 277
(a) A child who is covered under a family member's group 278
health benefit plan or under other private or employer health 279
insurance coverage, if the cost of the child's participation is 280
not greater than 5 percent of the family's income. If a child is 281
otherwise eligible for a subsidy under the Florida Kidcare 282
program and the cost of the child's participation in the family 283
member's health insurance benefit plan is greater than 5 percent 284
of the family's income, the child may enroll in the appropriate 285
subsidized Kidcare program. 286
(b) A child who is seeking premium assistance for the 287
Florida Kidcare program through employer -sponsored group 288
coverage, if the child has been covered by the same employer's 289
group coverage during the 60 days before the family submitted an 290
application for determination of eligibility under the program. 291
(c) A child who is an alien but who does not meet the 292
definition of a lawfully residing child. This paragraph does not 293
extend eligibility for the Florida Kidcare program to an 294
undocumented immigrant. 295
(d) A child who is an inmate of a public institutio n or a 296
patient in an institution for mental diseases. 297
(e) A child who is otherwise eligible for premium 298
assistance for the Florida Kidcare program and has had his or 299
her coverage in an employer -sponsored or private health benefit 300
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
plan voluntarily cancele d in the last 60 days, except those 301
children whose coverage was voluntarily canceled for good cause, 302
including, but not limited to, the following circumstances: 303
1. The cost of participation in an employer -sponsored 304
health benefit plan is greater than 5 p ercent of the family's 305
income; 306
2. The parent lost a job that provided an employer -307
sponsored health benefit plan for children; 308
3. The parent who had health benefits coverage for the 309
child is deceased; 310
4. The child has a medical condition that, without medical 311
care, would cause serious disability, loss of function, or 312
death; 313
5. The employer of the parent canceled health benefits 314
coverage for children; 315
6. The child's health benefits coverage ended because the 316
child reached the maximum lifetime covera ge amount; 317
7. The child has exhausted coverage under a COBRA 318
continuation provision; 319
8. The health benefits coverage does not cover the child's 320
health care needs; or 321
9. Domestic violence led to loss of coverage. 322
(6) A child who is otherwise eligible for the Florida 323
Kidcare program and who has a preexisting condition that 324
prevents coverage under another insurance plan as described in 325
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
paragraph (5)(a) which would have disqualified the child for the 326
Florida Kidcare program if the child were able to enroll in the 327
plan is eligible for Florida Kidcare coverage when enrollment is 328
possible. 329
(7) A child whose family income is above 300 250 percent 330
of the federal poverty level or a child who is excluded under 331
the provisions of subsection (5) may participate in the Florida 332
Kidcare program as provided in s. 409.8132 or, if the child is 333
ineligible for Medikids by reason of age, in the Florida Healthy 334
Kids program, subject to the following: 335
(a) The family is not eligible for premium assistance 336
payments and must pay the full cost of the premium, including 337
any administrative costs. 338
(b) The board of directors of the Florida Healthy Kids 339
Corporation may offer a reduced benefit package to these 340
children in order to limit program costs for such families. 341
(8) Once a child is enrolled in the Florida Kidcare 342
program, the child is eligible for coverage for 12 months 343
without a redetermination or reverification of eligibility, if 344
the family continues to pay the applicable premium. Eli gibility 345
for program components funded through Title XXI of the Social 346
Security Act terminates when a child attains the age of 19. A 347
child who has not attained the age of 5 and who has been 348
determined eligible for the Medicaid program is eligible for 349
coverage for 12 months without a redetermination or 350
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
reverification of eligibility. 351
(9) When determining or reviewing a child's eligibility 352
under the Florida Kidcare program, the applicant shall be 353
provided with reasonable notice of changes in eligibility whic h 354
may affect enrollment in one or more of the program components. 355
If a transition from one program component to another is 356
authorized, there shall be cooperation between the program 357
components and the affected family which promotes continuity of 358
health care coverage. Any authorized transfers must be managed 359
within the program's overall appropriated or authorized levels 360
of funding. Each component of the program shall establish a 361
reserve to ensure that transfers between components will be 362
accomplished within current year appropriations. These reserves 363
shall be reviewed by each convening of the Social Services 364
Estimating Conference to determine the adequacy of such reserves 365
to meet actual experience. 366
(10) In determining the eligibility of a child, an assets 367
test is not required. If eligibility for the Florida Kidcare 368
program cannot be verified using reliable data sources in 369
accordance with federal requirements, each applicant shall 370
provide documentation during the application process and the 371
redetermination process, including, but not limited to, the 372
following: 373
(a) Proof of family income, which must be verified 374
electronically to determine financial eligibility for the 375
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
Florida Kidcare program. Written documentation, which may 376
include wages and earnings stateme nts or pay stubs, W-2 forms, 377
or a copy of the applicant's most recent federal income tax 378
return, is required only if the electronic verification is not 379
available or does not substantiate the applicant's income. 380
(b) A statement from all applicable, employ ed family 381
members that: 382
1. Their employers do not sponsor health benefit plans for 383
employees; 384
2. The potential enrollee is not covered by an employer -385
sponsored health benefit plan; or 386
3. The potential enrollee is covered by an employer -387
sponsored health benefit plan and the cost of the employer -388
sponsored health benefit plan is more than 5 percent of the 389
family's income. 390
(c) To enroll in the Children's Medical Services Network, 391
a completed application, including a clinical screening. 392
(11) Subject to paragraph (5)(a), the Florida Kidcare 393
program shall withhold benefits from an enrollee if the program 394
obtains evidence that the enrollee is no longer eligible, 395
submitted incorrect or fraudulent information in order to 396
establish eligibility, or failed to p rovide verification of 397
eligibility. The applicant or enrollee shall be notified that 398
because of such evidence program benefits will be withheld 399
unless the applicant or enrollee contacts a designated 400
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
representative of the program by a specified date, which must be 401
within 10 working days after the date of notice, to discuss and 402
resolve the matter. The program shall make every effort to 403
resolve the matter within a timeframe that will not cause 404
benefits to be withheld from an eligible enrollee. 405
(12) The following individuals may be subject to 406
prosecution in accordance with s. 414.39: 407
(a) An applicant obtaining or attempting to obtain 408
benefits for a potential enrollee under the Florida Kidcare 409
program when the applicant knows or should have known the 410
potential enrollee does not qualify for the Florida Kidcare 411
program. 412
(b) An individual who assists an applicant in obtaining or 413
attempting to obtain benefits for a potential enrollee under the 414
Florida Kidcare program when the individual knows or should have 415
known the potential enrollee does not qualify for the Florida 416
Kidcare program. 417
Section 5. Subsection (3) of section 409.816, Florida 418
Statutes, is amended to read: 419
409.816 Limitations on premiums and cost sharing. —The 420
following limitations on premiums and cost sharing are 421
established for the program. 422
(3) Enrollees in families with a family income above 150 423
percent of the federal poverty level who are not receiving 424
coverage under the Medicaid program or who are not eligible 425
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
under s. 409.814(7) may be requ ired to pay enrollment fees, 426
premiums, copayments, deductibles, coinsurance, or similar 427
charges on a sliding scale related to income, except that the 428
total annual aggregate cost sharing with respect to all children 429
in a family may not exceed 5 percent of t he family's income. 430
However, copayments, deductibles, coinsurance, or similar 431
charges may not be imposed for preventive services, including 432
well-baby and well-child care, age-appropriate immunizations, 433
and routine hearing and vision screenings. Premiums for 434
enrollees paying enrollment fees, premiums, copayments, 435
deductibles, coinsurance, or similar charges as provided in this 436
subsection shall be based on at least three but no more than 437
five tiers of uniform premiums that increase with each tier as a 438
percentage of the applicable threshold amount of the federal 439
poverty level, by tier. 440
Section 6. Paragraph (b) of subsection (2) of section 441
624.91, Florida Statutes, is amended to read: 442
624.91 The Florida Healthy Kids Corporation Act. — 443
(2) LEGISLATIVE INTE NT.— 444
(b) It is the intent of the Legislature that the Florida 445
Healthy Kids Corporation serve as one of several providers of 446
services to children eligible for medical assistance under Title 447
XXI of the Social Security Act. Although the corporation may 448
serve other children, the Legislature intends the primary 449
recipients of services provided through the corporation be 450
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
school-age children with a family income equal to or below 250 451
200 percent of the federal poverty level, who do not qualify for 452
Medicaid. It is also the intent of the Legislature that state 453
and local government Florida Healthy Kids funds be used to 454
continue coverage, subject to specific appropriations in the 455
General Appropriations Act, to children not eligible for federal 456
matching funds under Tit le XXI. 457
Section 7. Effective July 1, 2024, paragraph (b) of 458
subsection (2) of section 624.91, Florida Statutes, as amended 459
by this act, is amended to read: 460
624.91 The Florida Healthy Kids Corporation Act. — 461
(2) LEGISLATIVE INTENT. — 462
(b) It is the intent of the Legislature that the Florida 463
Healthy Kids Corporation serve as one of several providers of 464
services to children eligible for medical assistance under Title 465
XXI of the Social Security Act. Although the corporation may 466
serve other children, the Legislature intends the primary 467
recipients of services provided through the corporation be 468
school-age children with a family income equal to or below 300 469
250 percent of the federal poverty level, who do not qualify for 470
Medicaid. It is also the intent of th e Legislature that state 471
and local government Florida Healthy Kids funds be used to 472
continue coverage, subject to specific appropriations in the 473
General Appropriations Act, to children not eligible for federal 474
matching funds under Title XXI. 475
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
Section 8. Except as otherwise expressly provided in this 476
act, this act shall take effect July 1, 2023. 477