KidCare funding dilemma sets off heated budget debate

Published: Saturday, April 1, 2006 at 6:01 a.m.
Last Modified: Friday, March 31, 2006 at 10:40 p.m.
In the last two years the number of kids getting state-subsidized health insurance coverage in Escambia County, which includes Pensacola, has dropped from 3,500 to 2,000.
Lucie Wade, who works with the United Way there trying to help families enroll in the program, called KidCare, says it's not because the need has dropped.
"We know we've got uninsured kids," Wade said.
The drop in enrollment started a couple years ago when state officials tried to crack down on fraud and made it tougher to enroll. Since then, the state has backed off that approach, and once again made it easier for parents to get their children coverage, which costs families $20 a month or less.
But advocates like Wade say they aren't getting the money they need to do the community-based outreach - going into schools and after-school programs, or even door to door - to make sure parents know about the program and how to enroll.
"We do the best we can, but we don't have any full time staff," Wade said. "Our resources are very limited."
The drop in enrollment created a conundrum that has given rise to one of the most contentious debates of the Legislature's effort to write a state budget for the coming year.
Last year, lawmakers put enough money in the budget to cover almost 350,000 children in KidCare. But current statewide enrollment is under 200,000. That leaves a huge surplus of money that isn't being used.
Republicans in the House and Senate both want to scale back the amount spent on KidCare to more closely match the number of children enrolled so that money isn't wasted.
That's backward, say advocates who work with families to get children insured. They ask: Instead of cutting KidCare spending to match enrollment, why not try to boost enrollment to match the budget?
Right now, both the House and Senate have written budgets that reduce the money going to KidCare - although lawmakers and KidCare officials are quick to point out that they plan to spend enough to cover not only every child currently in the program, but additional ones too, so it may be misleading to call it a budget cut.
" 'Cuts' implies that someone's hurt, or that services are cut," said Rose Naff, director of Healthy Kids, which runs the program. "This is a budget alignment."
"Saying we're cutting spending for KidCare by 60 or 80 million dollars, that's spinning it in the wrong way," said House Speaker Allan Bense, R-Panama City. "Every child in that program will be funded."
The Senate has proposed budgeting about $170 million less next year than it did this year, and the House would go further, reducing the budget by more than $200 million. That would bring the program's budget in line with what lawmakers think is needed to cover the children expected to enroll.
But activists say if there were more spending on outreach like Lucie Wade does, there would be lots more kids in the program and all that extra money might be needed. State law used to require some money go specifically for outreach, but that requirement was written out of the law. KidCare can't spend the extra money it has on outreach, because it doesn't have the authority under the current budget law to do so.
"You have to restore the outreach and you have to be in the community," said Karen Woodall, a longtime capitol children's advocate.
The money would go to help make sure people like Jennifer Craddock get their kids into KidCare. She'd never heard of it and was about to lose coverage for her children under Medicaid because her family's income went up.
Lucie Wade delivered a flier to her child's preschool and helped her enroll 5-year-old Hannah and 3-year-old Braden, who has asthma and badly needs coverage for his medicine.
"I had no idea about KidCare before I got the flier," said Craddock, a receptionist in a doctor's office. "If it wasn't for Lucie Wade, my children would not have insurance."
KidCare plans to announce a stepped-up marketing blitz to try to get more families like Craddock's to enroll. Lawmakers point to money spent on TV ads and other marketing as proof that the state is doing what it can to get the word out.
"But marketing and community outreach are not the same," said Woodall. Wade agrees, and said she sometimes has to walk families through the enrollment process, and make sure they get their child into the right program.
Woodall has urged the Legislature to earmark for KidCare roughly what was in last year's budget, and use some of the money not needed for covering kids to boost community outreach.
Rep. Joe Negron, the chairman of the committee that writes the House budget, said the idea that the state isn't spending enough on getting the word out and helping people enroll is "simply not true."
"We're making it very easy for people to know about," said Negron, R-Stuart. "We are reaching out, we are letting people know about it.... We want to fund every child who is eligible for the program."
He said his child has brought home information from school and he thinks most schools send similar info home.
But Negron said that the state can only do so much - that at some point parents have to follow through and sign up.
"There's some personal responsibility" required, Negron said.
Woodall said that even though neither the House nor the Senate budget plans would spend as much this year as last, activists are hoping lawmakers will increase their spending plans next month when new estimates of how much tax money the state has available to spend come in.

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