Opinion: Help children by need, not county

Gov. Jeb Bush and lawmakers are once again sparring over the "local match" mandate in the Healthy Kids program, and the welfare of Florida's needy children rests on the outcome. Retaining the match, under which counties must contribute financially once a minimal number of base slots have been filled, would mean the continuing loss of millions of federal dollars and, worse, denial of health-insurance coverage for thousands of low-income children. While the local match may once have been good policy, its liabilities have come to exceed its benefits. It should be eliminated so that coverage is determined by what our children need, not by which county they happen to call home.

The maneuvering is only the latest turn in a long-running debate. Last spring, lawmakers tried to get rid of the local match through proviso language in the budget, but the back-door attempt drew a legal challenge from Bush. They took a more direct approach during the December special session, eliminating the match by statute for fiscal year 2001-02. The current jousting is over what happens next year and beyond. A group of lawmakers, led by Republicans Burt Saunders and Jack Latvala in the Senate and Frank Farkas, among others, in the House, is pushing proposals (SB 142 and HB 1137) to replace the local match with state dollars. A competing bill, filed by Sen. Ron Silver, D-North Miami, and supported by Bush (SB 1980), would retain the match, penalizing recalcitrant counties through cigarette-tax deductions.

The Silver bill would hurt children far more than it would hurt counties. Since the early 1990s, many counties have come up with the match. Some, such as Pinellas, contribute at a far higher dollar amount than others. But others have been unable or unwilling to contribute. In those counties, children are put on waiting lists. In four counties that recently failed to pay their match, more than 5,000 eligible children waited up to a year for coverage. Many are likely still without it. Legislative auditors recently warned that retaining the local match could translate into delayed or denied treatment, or expensive emergency-room care, for more uninsured children.

The local-match barrier is one reason Florida recently had to send millions of unused dollars back to the federal government. For every dollar the state puts into Healthy Kids, it receives an extra $2.23 in federal child-health money. To date, Florida has failed to spend more than $100-million in federal dollars, and millions more sit in Washington, available for the taking.

It would be nice if all counties were able and willing to pay. But they are not, and Florida children should not have to pay the price. That's especially true when the feds stand ready to help pick up the tab.

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