TALLAHASSEE, Fla. — A Leon County judge has rejected an attempt to force Florida health officials to implement a long-delayed expansion of Florida KidCare that could make subsidized health insurance available to tens of thousands of additional children.
Circuit Judge Joshua Hawkes ruled that the families challenging the state must first pursue their claims through Florida’s administrative hearing process rather than seeking immediate relief in circuit court.
The four-page ruling does not invalidate the 2023 expansion law or resolve the broader disagreement over when Florida must implement it. Instead, it concludes that the plaintiffs used the wrong legal avenue to challenge coverage decisions by the Agency for Health Care Administration and the Florida Healthy Kids Corporation.
The ruling was first reported Tuesday evening by Florida Phoenix.
“Petitioners simply do not have a cause of action in this Court,” Hawkes wrote.
The judge said families can challenge eligibility determinations through administrative proceedings. Final agency decisions can then be appealed to a state appellate court.
Florida KidCare Expansion Remains Delayed
The Florida Legislature unanimously approved House Bill 121 in 2023, raising the income limit for subsidized KidCare coverage from 200% to 300% of the federal poverty level.
Gov. Ron DeSantis signed the bill into law, and its provisions were scheduled to take effect Jan. 1, 2024. The law also directed the Florida Healthy Kids Corporation to create new income-based premium tiers for participating families.
A legislative staff analysis estimated that approximately 42,000 uninsured children lived in households earning between 200% and 300% of the federal poverty level when lawmakers considered the measure. The analysis projected that more than 16,000 children could enroll during the first year.
More recent court filings cited by health-care advocates estimate that as many as 68,000 uninsured children now live within the expansion’s income range. The figures reflect different estimates and periods rather than a single official enrollment projection.
Despite legislative approval, the higher eligibility limit has not been implemented.
Federal Coverage Requirement Fuels Dispute
The delay is tied to a separate disagreement between Florida and the federal government over continuous health coverage for children.
The federal Centers for Medicare and Medicaid Services approved Florida’s KidCare expansion waiver on Dec. 2, 2024. The approval remains effective through September 2029.
However, federal law requires states to provide children younger than 19 with 12 months of continuous eligibility after they enroll in Medicaid or the Children’s Health Insurance Program. The federal rule also prevents states from terminating coverage during that period because of missed premium payments.
Florida has challenged the requirement in federal court, arguing that it interferes with the state’s premium structure and administration of KidCare.
State officials have maintained that the federal conditions must be resolved before the expansion can be implemented. Health-care advocates counter that federal approval has already been granted and that Florida must enforce the eligibility limit approved by lawmakers.
Families Sought Court Order
The Florida Health Justice Project and National Health Law Program filed the lawsuit in March on behalf of three children.
The complaint asked the court to require AHCA and the Florida Healthy Kids Corporation to evaluate the children under the 300% income limit established in state law.
Hawkes agreed with the state that the families must first challenge their individual coverage determinations administratively. He also found that the Florida Healthy Kids Corporation could not be sued under the legal theory presented in the case.
The decision leaves the families free to pursue administrative hearings and subsequent appeals, but it denies their request for an immediate court order requiring statewide implementation.
What Happens Next
The ruling means Florida’s existing KidCare income limit remains in use while the families decide whether to pursue administrative challenges.
The 2023 expansion law also remains on the books, and the federal government’s approval remains active. Unless state officials implement the program voluntarily, the next stage of the dispute is likely to unfold through administrative hearings, appellate litigation or further legislative action.
For families whose incomes exceed the current subsidized limit, the wait for expanded coverage continues.
Sources
- Florida KidCare ruling coverage — Florida Phoenix
- CS/CS/HB 121 — Florida Senate
- Florida House staff analysis of HB 121
- CMS approval of Florida’s KidCare eligibility extension
- CMS guidance on continuous eligibility
- Original lawsuit announcement
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