KidsWell Florida: Practical solutions to cover all kids

Wednesday, May 30th Noon to 1 pmAudio:  866.740.1260 

Access Code: 9565473 

PROGRAM

• Welcome

• What is Florida KidsWell?

• Uninsured Florida kids: It doesn’t have to be this way- Dr. Louis St. Petery

• Discussion/ Q&A

• KidsWell Florida- bringing it all together

• KidsWell Florida next steps

• Q&A

• Adjourn

WHAT IS KIDSWELL FLORIDA?

• Collaborative grassroots movement to BUILD UPON and EXPAND existing efforts to get kids health coverage

• Connects community organizations, providers, families, businesses, and the public to build support for and achieve policy solutions

WHAT IS KIDSWELL FLORIDA?

• Staffed, long term investment to help you

• Research, organizing, communications and advocacy resources to get the job done

• Nationally supported and successful campaigns: TX, NM, CA, NY, PA, MD & now Florida

• We need EVERYONE!

WE CAN DO BETTER FOR FL KIDS

The Henderson FamilyWest Palm Beach

WE CAN DO BETTER

Dawn JosephsonJacksonville

COMPLEX SYSTEM, GAPS IN COVERAGE, FRUSTRATION…

• Video inserted here Kendra Garcia

HOW IS FL DOING IN COVERING KIDS?

HOW IS FLORIDA DOING IN COVERING KIDS?

FLORIDA LED NATION IN DECLINE RATE OF UNINSURED CHILDREN IN 2008-2010

Source: Georgetown University Center for Children and Families, “Despite Economic Challenges, Progress Continues: Children's Health Insurance

Coverage in the United states fro m2008-2010”

2008 Uninsured Rate 2010 Uninsured Rate0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

9.0%8.0%

16.7%

12.7%

NationalFlorida

FLORIDA STILL HAS MANY UNINSURED CHILDREN - IN BOTH

RELATIVE & ABSOLUTE TERMS

All Kids Uninsured Kids0%1%2%3%4%5%6%7%8%9%

10%

5.4%

8.6%

Percent of U.S. Total in Florida (2010)

507,000out of

5.9 millionuninsured U.S. kids

were Floridi-ans

CHILDREN’S MEDICAID/CHIP PARTICIPATION RATES BY STATE (2008)

FloridaGeorgia

AlabamaMississippi

South CarolinaNorth Carolina

VirginiaTennessee

TexasCaliforniaNew York

US

0% 20% 40% 60% 80% 100%

70%

85%81%

85%

87%75%

89%82%

Source: Who And Where Are The Children Yet To Enroll In Medicaid And The Children's Health Insurance Program?, Health Affairs, October 2010, http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2010.0747.

COMPLEX ELIGIBILITY SYSTEM

ADMINISTRATIVE COMPLEXITY

FLORIDA - THE DONOR STATE

• Millions of federal dollars lost over the last two decades due to low enrollment

• CHIP awards funding not used to other states and Florida repeatedly missing out on much needed dollars

• Title XXI higher match rate than Medicaid in KidCare at 70/30

• Even more money was lost from CHIPRA bonuses

COVERAGE MAY NOT MEAN ACCESS

• Strained providers/Low provider participation - Legal challenge over inadequate provider reimbursement rates

• Barriers to access (e.g., rural areas)

• Delays in care due to gaps when transitioning between KidCare components

• Obstacles raised by for-profit managed care plans

WHAT DOES FL’S PUSH FOR STATEWIDE MEDICAID MANAGED CARE MEAN FOR KIDS?

• Florida Medicaid 1115 waiver operating in 5 counties requires all children to enroll in managed care or PSN since 2006

• 76% of participants in “Medicaid Reform Pilot” are children and parents

• Approval of expansion STILL PENDING and many health advocates urging CMS to deny waiver amendment

FLORIDA CHILD HEALTH WINS

• 2008 – State bureaucratic barriers removed:• Added exemptions to waiting period for kids who

leave private coverage to qualify• Reduced waiting period for those not exempt

• 2009 – Federal reauthorization of CHIP until 2019

FLORIDA CHILD HEALTH WINS

• 2010 – Federal ACA ends exclusion of coverage for pre-existing conditions for children in private health plans

• 2010 – Federal prohibition on tightening eligibility in Medicaid and CHIP until 2019• e.g., Rejection of State’s proposed $10 premium

requirement

FLORIDA CHILD HEALTH WINS

• 2012 – State legislation extending KidCare eligibility to children of State employees

• 2012 - State legislation setting in motion plan for “no wrong door” coordinated enrollment and eligibility system (ACA implementation)

• 2013 – Federal increase in Medicaid reimbursement rates for primary care to Medicare levels (though State has not yet approved)

OPPORTUNITIES

• #1) Administrative (KidCare-related)

• Identify eligible children through free and

reduced lunch data

• Eliminate unnecessary administrative

requirements (Demanding that families

produce paperwork for SSA match)

• Implement seamless, real-time eligibility determination

• Reduced “churning”

OPPORTUNITIES

• #2) State Legislation (Kid-Care related)

• Expand coverage to lawfully residing immigrant children

• Implement “Express Lane” eligibility

• Implement presumptive eligibility

• Implement 12-month continuous eligibility in all KidCare components

OPPORTUNITIES

• #2) State Legislation (Kid-Care related)

• Full utilization of CHIP funding

• “Full-pay” coverage option for infants

• Restore outreach funding

FEDERAL HEATH CARE REFORM IMPACT ON MEDICAID COVERAGE

Infants Pregnant Women

Young Children

School-Age

Children

Adults with

Disabili-ties

Parents Childless Adults

0%

50%

100%

150%

200%200%

185%

133%

100%

74%

20%0%

133%

Health Reform

Current Law

% o

f Fed

era

l P

overt

y Level

74%

100%

Children Undocumented Immigrants

Adults w/o Children

Seniors/People with

Disabilities

ParentsPregnant Women

■ Current Medicaid and CHIP (Florida 2011 eligibility levels)■ Uninsured or insured via other source of coverage

185%200%

Health Insurance

Exchange(s)

Subsidized

No subsidy

2014

20%

200%

300%

400% of poverty level

Not eligible now

133%Medicaid Expansion

FEDERAL HEATH CARE REFORM IMPACT ON COVERAGE

FEDERAL HEATH REFORM OPPORTUNITIES

• Increases coverage opportunities for families through Medicaid and affordability credits through the Exchange

• Ends complex, “stair-step” eligibility in KidCare

• Removes premium payment requirement

for some school-age kids

• Removes asset test for parents

• Streamlines and simplifies eligibility and enrollment

• Expedites or automates renewals

WHAT ABOUT THE SUPREME COURT ACA CHALLENGE?

DISCUSSION

•Questions?

HOW DO WE GET THERE?

• Strengthen collective action

• Raise consumer voices

• Research- feedback from the field, policy analysis and research

• Speak with shared messages and many voices- develop effective messaging

• Campaign strategically

KIDSWELL PUBLIC LAUNCH SEQUENCE

• June - July - August• Regional meetings focusing on

identifying consumers, building grassroots support and identifying strategic campaigns

KIDSWELL PUBLIC LAUNCH SEQUENCE

• September - Public Launch• Media event announcing KidsWell formation• Release of report• Full website• Op-eds, LTEs and other earned media

• Post September• Advocacy agenda formed• Advocacy campaigns launched

KidsWell Florida Organizational Chart

Region 6

Region 7

Region 8

Region 9

Region 10

Region 11

Region 1

Region 2

Broward Palm Beach

Region 3

Region 4

Region 5

Executive Committee

1 to 2 Representatives from each KidsWell Regional Committee

Miami-Dade Monroe

Hillsborough Pinellas

Pasco Polk

Orange Seminole Volusia

Alachua Duval

Manatee Sarasota

Treasure Coast

Counties

Escambia Bay

Leon Lee Collier

Lead Collaborators provide support to the Executive Committee and Regional Committees by staffing meetings and events, building and maintaining the coalition infrastructure, and providing educational materials, advocacy opportunities, and technical expertise.

The Executive Committee provides feedback and directional support to the Leadership team and is supported by the Regional Committees.

The Regional Committees plan and execute advocacy campaigns, deliver educational presentations, and provide “on the ground” information about policy priorities.

Lead Collaborators

Florida CHAIN, Children’s Movement, FCFEP, FCHC, Children’s Trust

Lead Collaborators

Florida CHAIN, Children’s Movement, FCFEP, FCHC, Children’s Trust

KIDSWELL FLORIDA REGIONS

UPCOMING REGIONAL MEETINGS

June• 6-19: Region 1 (Miami-Dade, Monroe) • 6-20: Region 2 (Broward, Palm Beach)• 6-26: Region 3 (Hillsborough, Pinellas)• 6-27: Region 4 (Orange, Seminole, Volusia)• 6-28: Region 5 (Alachua, Duval)

July• 7-10: Region 6 (Manatee, Sarasota)• 7-11: Region 7 (Pasco, Polk)• 7-12: Region 8 (Treasure Coast counties)• 7-24: Region 9 (Escambia – Bay)• 7-25: Region 10 (Leon)• 7-26: Region 11 (Lee/Collier)

REGIONAL MEETINGS

• Discuss and deliberate potential policy issues and areas of focus

• Gather everyone’s input and thoughts related to potential policy/issues with hopes of reaching consensus

• Identify potential executive committee members for respective region

• Discuss building regional capacity for advocacy activity on both regional and statewide levels

WEB/SOCIAL MEDIA

• Website: www.kidswellflorida.org

• Social Media:• Facebook www.facebook.com/KidsWellFlorida

• Twitter- @KidsWellFL

DISCUSSION/Q&A

NEXT STEPS

CONTACT

Nick DuranKidsWell Organizer

nduran@kidswellflorida.org

954-547-6165

Linda MerrellKidsWell Organizer

lindakids1@aol.com