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All children need coverage

This is a critical time for the future of efforts to provide badly needed health care coverage to uninsured children. In Washington, President Bush and Congress are preparing to renew the 10-year-old state Children's Health Insurance Program but are arguing over money and coverage limits. In Tallahassee, Gov. Charlie Crist is recommending a reasonable increase in spending on Florida's version of the program, which is still recovering from earlier shortsighted efforts to rein in the cost. The focus in both capitals should be on covering as many children as possible, eliminating red tape and avoiding changes that could take health care away from some kids.

The Florida Healthy Kids program, created in 1990, offers health insurance with small premiums to school-age children whose families earn too much money to qualify for Medicaid but not enough to afford private coverage on their own. The benefits are clear - those children receive basic care that enables them to stay healthier and do better in school, and they avoid receiving primary care in expensive emergency rooms at public expense.

That logic was lost on Gov. Jeb Bush and the Legislature in 2004, when they were so embarrassed by long waiting lists for Healthy Kids that they eliminated the list and started limiting enrollment periods. The predictable result was that enrollment dropped by more than 100,000 children over the next year. That mistake has been corrected and children can be enrolled year round again, but that foolishness, limited outreach efforts and bureaucracy have prevented Healthy Kids from reaching its potential.

The good news is that applications in January were up by 50 percent over January 2006 and more than 230,000 children are being covered. The bad news is that the state's own stinginess means it has not been spending all of its federal matching money. Florida just lost $20-million in federal dollars that will be redirected to another state. Still, Healthy Kids will spend some of its federal reserves as it continues to add children this year, and that means it will be important when those reserves run out down the road for Washington to increase annual spending.

President Bush has recommended an increase in spending, but Democrats in Congress say it will not be enough to address the problem. The president's call to stop states from using this pot of money to cover adults could help Florida (which appropriately uses it for children only), but his tighter income eligibility limits and eagerness to move around unspent money would be a problem.

Meanwhile, state legislators are taking another look at how to streamline health insurance programs for uninsured children, step up marketing efforts and make sure kids don't get caught in limbo between Medicaid and Healthy Kids. Chief Financial Officer Alex Sink, as the chair of the nonprofit Healthy Kids Corp. board of directors, should keep a close eye on the finances to ensure that the state spends its money effectively and doesn't lose any more federal matching dollars.

The lack of health coverage is regaining the spotlight in Tallahassee and Washington. Despite Healthy Kids' successes, more than 750,000 Florida children still have no health coverage. That is unacceptable.

[Last modified February 7, 2007, 20:56:00]