KidCare expansion to 300% FPL stalled as state and CMS dispute premium‑payment rule; litigation ongoing

Florida’s plan to expand the KidCare program to 300 percent of the federal poverty level, enacted as House Bill 121, has not been implemented because of a dispute with the federal government over CHIP premium‑payment and disenrollment rules, Deputy Secretary Brian Meyer said at the Senate Health Policy Committee.

Meyer outlined the procedural history the agency presented to senators: the state sought to implement the statutory expansion and submitted a Section 1115 demonstration waiver in May 2025. CMS provided special terms and conditions (STCs) and, according to AHCA, included a federal interpretation that CHIP enrollees cannot be disenrolled for nonpayment of premiums — an interpretation AHCA and the state challenged in federal court.

Meyer told senators that the disagreement traces to CMS FAQs and a subsequent rulemaking the agency issued in late 2023 that the state believes conflicts with Florida’s statutory design for premium tiers and the state’s ability to disenroll for nonpayment. AHCA said it received STCs, attempted to negotiate, and subsequently filed litigation challenging CMS’s interpretation; the state and federal government have exchanged filings and agreed to stays while they discuss alternative paths to implementation.

Senators and public witnesses said the delay has real‑world consequences. Public commenters described families who say they lost coverage during the Medicaid unwinding and must either pay high premiums or forgo care. One speaker said 67,000 additional children became uninsured in Florida after the unwind and that more than 400,000 children are uninsured — comments attributed to public advocates during committee testimony; AHCA said it would follow up with data requests to Healthy Kids Corporation and other partners.

Ending: AHCA told the committee it remains committed to implementing HB 121 but that federal rule interpretation and litigation have prevented implementation to date. The agency said it is exploring alternative approaches with the Department of Justice and CMS to enable the expansion while addressing legal objections.