Florida KidCare: only state removing kids from coverage

Florida KidCare – Florida is removing thousands of children from KidCare for missed premium payments while other states follow federal continuous coverage rules.

Florida’s treatment of children enrolled in its low-income health program is drawing sharp legal and political fire, with critics calling the state an outlier for cutting off coverage over missed premiums.

U.S. Rep. Kathy Castor, a Democrat from Florida, said in a post dated April 29 that Governor Ron DeSantis is “breaking the law,” arguing Florida is the only state “kicking children off their affordable health coverage” and preventing more than 40,000 children from getting KidCare coverage.

KidCare is Florida’s subsidized health insurance program for children from low-income families.. It is the state’s version of the federal Children’s Health Insurance Program, commonly known as CHIP.. Federal policy plays a central role in the dispute: a rule requires states to keep children continuously enrolled in affordable subsidized coverage for 12 months even if parents miss a payment.

Florida officials have challenged that federal continuous-enrollment requirement in court and have argued for exemptions tied to how KidCare works in practice.. Yet federal compliance has remained a sticking point.. Florida officials removed about 43,000 children from December 2024 through November 2025, according to data obtained by a health policy organization.

Two of Florida’s lawsuits seeking relief from the continuous coverage rule were unsuccessful, while a third case remains pending.. The DeSantis administration has filed litigation involving both the Biden and Trump administrations. aiming to either exempt Florida from the requirement or reverse the rule itself.

Supporters of the federal approach say the core purpose of the continuous eligibility requirement is to prevent families from losing coverage due to nonpayment or administrative errors.. Joan Alker. director of Georgetown University’s Center for Children and Families. said Florida is removing thousands of children while violating federal law and declining to expand KidCare because of the federal rule.

Castor’s remarks also highlighted a broader pattern: Florida’s yearslong delay in expanding KidCare, even after state lawmakers approved an expansion in 2023. Castor shared material from a health policy think tank discussing that delay, according to her social media post.

When asked for comment, a spokesperson for Castor pointed to that policy analysis, and argued that other states, including Texas, have sought changes to the same continuous-coverage requirement through federal channels rather than defying it.

Florida’s administration, for its part, directed questions to the state’s Agency for Health Care Administration, which oversees KidCare and has been involved in the litigation. The agency did not respond to an email seeking comment.

KidCare’s design ties together state law, federal funding, and family premiums.. Florida’s program functions as a Medicaid expansion for children whose families earn too much to qualify for traditional Medicaid but not enough to purchase private or marketplace coverage.. Federal funding covers about 69 cents of every dollar spent on KidCare. with the remainder coming from state funds and monthly premiums ranging roughly from $15 to $20. depending on household income.

Florida has among the highest numbers of uninsured children in the country. Based on 2024 federal data, more than 400,000 children in Florida were uninsured, representing 8.5%.

In May 2023, Florida’s legislature approved expanding KidCare eligibility from 200% to 300% of the federal poverty level, with DeSantis signing the change into law in June 2023. A 2023 House analysis estimated the expansion would cover about 42,000 additional children.

The expansion fight is tightly linked to how federal and state rules interact.. The federal government approved the continuous eligibility rule in 2023. requiring states to provide 12 months of coverage for children enrolled in subsidized programs.. The policy is intended to reduce disruptions when families experience nonpayment or procedural issues.

Alker noted that children sometimes lose coverage due to bureaucratic mistakes, such as missing a notice when families move.

Florida’s administration pursued a waiver process to expand KidCare while seeking flexibility around the continuous eligibility requirement.. In December 2024. the Centers for Medicare and Medicaid Services approved Florida’s waiver for expansion. but required the state to comply with the federal continuous-enrollment rule.

Despite that condition, Florida removed about 43,000 children from December 2024 through November 2025 due to premium-payment lapses. Critics argue the removals conflict with the federal requirement, while Florida maintains it has legal grounds to challenge compliance.

The legal record includes a federal judge dismissal of Florida’s first lawsuit challenging the continuous coverage rule. and Florida’s withdrawal of a second lawsuit in February.. Now Florida is suing the federal government for a third time. alleging Freedom of Information Act violations related to the waiver approval and asking the court to strike the condition requiring compliance with continuous enrollment.

Florida advocates say the approach has both immediate and longer-term consequences.. Holly Bullard of the Florida Policy Institute. a left-leaning nonprofit. said Florida is an “extreme outlier. ” emphasizing that it is both the only state suing over the rule and the only one failing to comply with federal and state requirements.

Bullard also argued that Florida’s strategy does not align with legal obligations: while states can challenge federal rules in court, officials should comply in the meantime.

Outside the state government’s litigation, legal action from advocacy groups has also moved forward. The Florida Health Justice Project, along with the National Health Law Program, sued Florida’s Medicaid and KidCare agencies in March seeking to implement the approved KidCare expansion.

In the absence of enforcement or warnings, the dispute has intensified around whether federal officials have acted to compel compliance.. The Trump administration has not enforced the continuous eligibility rule in Florida or issued warnings to the state. according to the case record described by the policy and legal reporting.

Overall, Castor’s claim that Florida is the only state removing children from subsidized coverage has been rated accurate, grounded in the argument that Florida is failing to comply with the federal requirement and has removed at least 43,000 children from KidCare for nonpayment since December 2024.

For Florida families navigating the program, the stakes are immediate: continued coverage determines whether children can access routine care without interruption. For state officials, the dispute centers on whether federal rules should apply as written once waivers and litigation enter the picture.

Florida KidCare CHIP continuous eligibility rule Medicaid expansion Ron DeSantis federal lawsuits uninsured children