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Insurance rates in children's health program to rise
By MARGIE MENZEL
THE NEWS SERVICE OF FLORIDA
THE CAPITAL, TALLAHASSEE, August 31, 2015..........Thousands of children in the Florida Healthy Kids health-insurance program will see their rates jump as of Oct. 1 --- and state officials are blaming the federal Affordable Care Act.
The increases don't affect all children covered by the Florida Healthy Kids Corp., most of whom get subsidized insurance. But the increases affect children whose families pay the full amount for coverage.
"Despite the federal government's assurances that rates would drop and access would improve --- insurance rates increased, many providers canceled coverage, and the makeup of our coverage was forced to change," Healthy Kids CEO Rebecca Matthews wrote last week to families that are affected. "I assure you that we at FHK were as shocked and upset as each of you when we learned how much the coverage costs increased."
Those families currently pay $153 per child for monthly health-care coverage, according to the Healthy Kids website. But as of Oct. 1, their options will range from $299 per month with dental care to $205 per month without if they stay enrolled in Healthy Kids.
When the full-pay families were notified of the Healthy Kids rate hike in July, they were also advised of other options --- including private insurance and what's known as the Federally Facilitated Marketplace, where they could shop for lower rates under the Affordable Care Act, or Obamacare. They could also revisit the option of coverage with their parents' employers to see if it was available.
"We understand that it's a lot to process right now for them," Matthews said of the full-pay parents. "But in order to comply with the ACA, we needed to offer a different type of a plan, and we did. In fact, we offered two."
When the parents started calling the federal exchange, however, they were told there was no special enrollment period for them if they chose coverage through that program. Their children's Healthy Kids coverage would run out on Sept. 30, but they'd have to wait until January 2016 to qualify for the federal program.
Last week, though, Healthy Kids and federal officials agreed that the increase in Health Kids premiums was a "qualifying event," meaning that it qualified the full-pay families for a special enrollment period in the federal exchange starting Oct. 1.
Karen Woodall, a health-care activist and member of the state KidCare Coordinating Council, said Healthy Kids didn't notify federal officials of the need for the special enrollment period in a timely manner. The federal government had approved the Healthy Kids' replacement full-pay program in May.
"The families that applied and were turned down --- that could have been avoided," Woodall said. "But I don't think it was intentional. I think somebody just didn't think about checking on that."
Woodall also noted that the changes under Obamacare could provide many full-pay families with better benefits.
"The other good news is, now they can't be denied coverage because of pre-existing conditions, or because they've used their lifetime benefits," she said. "A number of families were in full-pay because of that. They were able to pay for insurance, but they couldn't get it."
Aaron Albright, a spokesman for the federal Centers for Medicare & Medicaid Service, confirmed the special enrollment period and additional benefits. Albright also noted that "the vast majority of consumers receive tax credits to make coverage more affordable."
Most families with children enrolled in Healthy Kids get subsidized coverage, for which they pay $15 to $20 a month for all their children. They have incomes between 133 percent and 200 percent of the federal poverty level. Currently, 144,124 Florida children get subsidized coverage, and 34,749 children are full-pay.
The families that pay the full amount for Healthy Kids coverage make more than 200 percent of the federal poverty line, but Woodall said those that earn between 200 percent and 300 percent are likely to qualify for subsidies under Obamacare.