Florida sues HHS over CHIP eligibility requirements

Florida is challenging rules from CMS that require states keep eligible children enrolled in Medicaid and CHIP for a full 12 months, even if their families do not pay premiums. 

New federal law took effect in 2024, requiring states to maintain 12 months of continuous eligibility for children enrolled in Medicaid and CHIP. According to guidance from CMS issued in late 2023, states that charge families premiums for CHIP coverage cannot disenroll children during their 12 months of continuous eligibility if their families do not pay monthly premiums. 

In a lawsuit filed in federal court Feb. 1, Florida argued the rules would "turn the program into a free-for-all, threatening its solvency, long-term stability and ability to reach even more children in need." 

The state charges families $15 to $20 per month for CHIP coverage, according to the lawsuit. Attorneys for the state argued CMS exceeded its authority by implementing the regulation and called its decision "arbitrary and capricious" without a "reasoned explanation." 

"These premiums offset program costs, ensure Florida maintains a balanced budget as required by its state constitution, and preserve Florida CHIP as a bridge between Medicaid and private insurance rather than an entitlement program," attorneys for the state wrote. 

In a Feb. 2 statement, Joan Alker, executive director of the Georgetown University Center for Children and Families in Washington, D.C., said if the lawsuit is successful, children in Florida will spend more time uninsured. 

"This is harmful and puts children's health and educational outcomes at risk in both the short and the long term," Ms. Alker said. 

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