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KidCare expansion to 300% FPL remains on hold as waiver dispute with CMS continues; advocates urge faster action
Summary
Agency officials told the committee that implementation of HB121 (KidCare/CHIP expansion to 300% of the federal poverty level) is delayed because CMS tied waiver conditions to a federal interpretation that prevents disenrollment from CHIP for nonpayment of premiums; advocates testified that families are already harmed by coverage gaps.
Deputy Secretary Brian Meyer told the Senate Health Policy Committee that House Bill 121, which would raise Florida’s KidCare (CHIP) income limit toward 300% of the federal poverty level, has not been implemented because the state’s waiver negotiation with the federal government was complicated by CMS’s interpretation of continuous eligibility and premium‑payment rules.
Meyer said the agency submitted an 1115 waiver to implement the expansion and received draft Special Terms and Conditions from CMS in November; the agency disputed provisions that the state viewed as inconsistent with the statute and later received an approval that the state did not accept. The agency sought extensions and engaged the incoming administration and later received communications that limited the normal negotiation timeline. Separately, Meyer said the state has filed litigation challenging CMS’s interpretation of continuous‑eligibility rules and remains in discussion with the Department of Justice and CMS to find a workable path forward.
"That's precisely why it hasn't been implemented," Meyer told the committee when asked whether litigation and CMS interpretation were the reason the income limits have not been raised.
Advocates and providers told the committee the delay has real consequences for families. Josie Barroso of Florida Voices for Health asked the committee to exercise oversight and move the expansion forward, citing stories of families in the coverage gap. Melanie Andrade Williams of the Florida Health Justice Project said her organization’s attorneys contend the state has sufficient authority to proceed and urged the agency to move ahead. "The federal government is not holding us hostage. Our own government is holding us hostage," Williams said, attributing the delay to state action as well as federal processes.
Committee members asked for data on how many children have been disenrolled for nonpayment of premiums and how many children remain uninsured because the income limits have not increased. Meyer said he did not have precise counts on hand but offered to work with the Florida Healthy Kids Corporation and provide numbers to the committee after the meeting.
Meyer said the agency has continued to press CMS and is exploring alternative approaches, including possibly negotiating different Special Terms and Conditions or other implementation pathways, but he could not predict a timetable for resolution.
