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Children of Legal Immigrants Will Soon Be Eligible For Coverage

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Thousands of children of legal immigrants will be closer to obtaining subsidized health insurance this summer, after the Legislature passed a long-debated expansion of the state's KidCare program.

Until this year, children of legal immigrants were technically eligible for KidCare --- the low-cost federal-state health insurance program --- but had to wait five years to actually start receiving services.

That changed on Thursday, when Gov. Rick Scott signed the state budget into law. Contained in an accompanying bill (HB 5101) was language eliminating the five-year wait.

As a result, more than 17,000 Floridians under age 19 will be eligible for coverage starting July 1, when the next state budget goes into effect.

If they qualify, they'll be covered under two federal programs: the Children's Health Insurance Program, or CHIP --- which includes KidCare --- and Medicaid. KidCare covers children in families who earn too much to qualify for Medicaid but not enough to afford private insurance.

According to the Florida Agency for Health Care Administration, 2,077 children of legal immigrants applied for KidCare coverage in the last year and were denied because they were still within the waiting period; they'll now be eligible for coverage that will cost their families a monthly premium between $15 and $20.

An additional 15,097 children could start receiving Medicaid coverage, for which they'd be eligible if their families earn up to 138 percent of the federal poverty level --- about $33,534 for a family of four.

"What it means is that there are a lot of kids that, probably, their life is going to be saved because they are going to be able to be taken care of," said Margarita Romo, executive director of Farmworkers Self-Help Inc., an advocacy group for migrant farm workers. "These are Americans. There is no reason why we should have unhealthy children in this country today.”

The proposal to expand coverage to legally residing children has been on the table since 2009, when Congress passed the Children's Health Insurance Program Reauthorization Act. That gave states the option of extending coverage to all such children immediately, by eliminating the waiting period.

Over the past four years, Sen. Rene Garcia, R-Hialeah, and Rep. Jose Felix Diaz, R-Miami, have sponsored bills to that effect in their respective chambers. Although the Senate came to embrace the idea, the proposal was heard in just one House committee during that time --- until Speaker Steve Crisafulli, R-Merritt Island, called for its passage in January.

Meanwhile, state estimates of what the measure would cost plummeted. The federal government would put up roughly $28 million, but the state's cost would be negligible.

Steve Freedman, a longtime board member of the Healthy Kids Corporation, which oversees KidCare, said the turning point for the bill's chances in Florida came last year. That's when the federal government agreed to pay 97 percent of the cost of enrolling a child in KidCare --- up from the 71 percent it had been paying.

"(Lawmakers) found out that given the new federal match rate, first of all it wasn't going to cost very much," Freedman said. "But then they looked at these kids' use of emergency services and ... they found out it would cost the state more to keep it the way it was than to change it."

Now the advocates' focus turns to outreach. Diaz said the figure of 17,000 eligible kids was based on real numbers of those who had applied for coverage and been denied.

"So right off the bat, you're going to have a great number of people that will apply organically," he said. "And a lot of children's groups are already getting the word out."

One is the Florida Covering Kids and Families program at the University Of South Florida's College of Public Health. Jodi Ray, its director, said her outreach efforts have long been focused on hard-to-reach families --- including those who had applied and been denied during the waiting period.

"We've been reaching these families for a long time," Ray said. "Now we can do more for them."

In addition to improving children's health, she said, the financial impact on families whose children qualify will be vast.

"Not only will they be able to afford the appropriate health care," she said, but they won't be forced to drain their resources for the purpose. "They'll also have more money to invest in other types of consumer spending."

Advocates say many families have not come forward in the past, however, out of anxiety about drawing the attention of immigration enforcement officials.

But now, said Amy Liem of Florida Legal Services, protections are in place for those who try to claim the benefits.

"The government has issued policy statements clarifying that information provided by applicants for public health benefits will not be used against them for enforcing immigration status," she said.

Many legal immigrants probably don't know that, Liem acknowledged, and even if they do, they're still wary.

But Diaz said if the outreach efforts prove problematic, lawmakers could help.

"If we see next year that a lot of kids are not coming forward or that we underestimated the amount of families that would apply, I'm sure there'll be some thought given to maybe allocating additional resources for outreach to families that might qualify but don't know they qualify," he said.