Local match' of funds called unfair

Poorer counties that can't ante up lose federal money for health care for needy kids. A group is pushing to void the match rule.

By SHELBY OPPEL

© St. Petersburg Times, published May 1, 2000

TALLAHASSEE -- With five days until the Legislature adjourns, critics say lawmakers aren't any closer to providing sufficient health insurance for the children of Florida's working poor.

Currently, the state pays the full tab for 500 children in each of 67 counties. For thousands more eligible children, their counties must share the cost.

The trouble is, many poorer counties can't raise the money. So the state spends less on those children, even as it prepares to return at least $18-million in unspent federal funds to Washington.

"We are discriminating against poor children in poor, rural counties," said Karen Woodall of the Florida Child Health Care Coalition, an alliance of 38 groups that includes the United Way, the state NAACP and the Hillsborough County Commission.

"Where we've got kids who really need it, we're cutting them out of the program."

With time running out at the Capitol, Woodall is trying to persuade lawmakers to remove the so-called "local match" requirement.

When it began, the match was heralded as an innovative way to expand insurance coverage for needy children. But that was before the federal government set aside $40-billion to help.

Now, Florida is the only state to require local communities to put up money in order to receive their share of the federal dollars.

Pinellas County is among 11 counties that contribute the full local match and therefore receive as much federal funding as the state allows, according to a report by the College of Public Health at the University of South Florida.

Hillsborough and Hernando counties, however, contribute less than the full match. They receive a share of state money proportional to what they raise. Citrus and Pasco don't raise any local money.

While federal dollars are available for poor children's health care in those counties, many kids simply don't get it.

Most children who qualify for the insurance have parents with minimum wage or low-paying jobs, including many who have recently moved off the welfare rolls. A family of three is eligible if the parents earn less than $27,760 annually.

State Insurance Commissioner Bill Nelson is chairman of the Healthy Kids Corporation's board of directors. The corporation administers the insurance program.

Nelson has urged lawmakers to eliminate the local match requirement. In the counties that have been contributing, the state should replace the $12-million that they collectively have paid with state funding, Nelson wrote in April 14 letters to Senate President Toni Jennings and House Speaker John Thrasher.

"While the local match served a valuable purpose in allowing (the state) to increase coverage to children in its early stages, many feel that it now creates inequities in a program required to provide coverage statewide," Nelson wrote.

As of now, though, the $12-million isn't part of the budget being negotiated in Tallahassee.

Rep. Elaine Bloom, D-Miami Beach, said she will try this week to attach an amendment to a House bill to remove the local match and replace the money with proceeds from the state's multibillion dollar settlement with tobacco companies.

The budget does include about $40-million to pay for health insurance for 102,000 more children. But, Woodall says, the 35 counties that don't raise any local match won't reap the benefit. Plus, the state must spend more than the $40-million to receive the total federal dollars available to Florida children.

In the past, House leaders and Gov. Jeb Bush have defended the local match. They don't appear to be changing their minds.

"The success of this program revolves around the state/county partnership," Rep. Ken Pruitt, the House budget chairman, said Friday.

"That's how it originally passed and we're staying with that original commitment," said Pruitt, R-Port St. Lucie.

Children's advocates, though, believe Jennings remains open to removing the local match in the waning days of the session.

"I am always open to the discussion," she said Friday, "as long as it means . . . more children covered."

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