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House KidCare Reform More Generous Than Senate's

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By CATHERINE DOLINSKI

The Tampa Tribune

Published: May 2, 2008

TALLAHASSEE - House legislation that initially pitted the needs of developmentally disabled children against those of the poor now contains reforms that advocates for poor children were seeking all along.

Those proposed revisions could put pressure on the Senate, where members passed a leaner insurance plan to cover autism and criticized the House bill for being too expansive and costly.

The Senate version would force large insurers to cover intensive therapies for autistic children only. The House's plan would require private and state-sponsored health insurance to cover children with autism, cerebral palsy, Prader-Willi syndrome, Down syndrome or spina bifida. The state benefit would be offered through KidCare, a subsidized health insurance program for low-income children.

Initially, the bill would have launched the KidCare portion in the middle of the coming fiscal year, raising alarms about funding in a lean budget year. The cost of the program remains unclear, but the only source of money identified by House leaders was $13.4 million that had been set aside to expand enrollment of low-income children in KidCare.

By Tuesday night, however, it included a start date for the new KidCare coverage - Oct. 1, 2009, after private insurers must start offering the coverage - eliminating the immediate impact on the coming fiscal year's budget. It also contained a new 5 percent cap on increases in KidCare premiums that could result from offering the costly developmental disorder benefit.

Karen Woodall, longtime lobbyist on health care issues, said that she and other child advocates are now pushing the revised House version because it would also streamline KidCare, making it easier for families to enroll and harder for them to lose coverage as a result of age or income changes.

Members of both parties have been pushing for such improvements to the KidCare program for years and nearly won them in spring 2007, when the legislation failed in the Senate during the final hours of the legislative session.

With all of the recent changes and additions to the KidCare portions of the House bill, Woodall and her colleagues now want the Senate to adopt it.

"We had not, until they fixed it. It's morphed into something that's very workable," she said. "It's not perfect, but nothing here ever is"

Senators from both parties want the streamlining portions of the bill, said Sen. Nan Rich, D-Sunrise, who sponsored a bill containing similar provisions. "Hopefully we will get them through one bill or another."

Rich, however, said she remains torn over the House autism bill. Though the costs will not have an impact on the 2008-09 budget, she said, it will almost certainly cost millions of dollars in later years - and could, therefore, still jeopardize money needed to subsidize enrollment of the low-income children in the KidCare program.

Senate Minority Leader Steve Geller, sponsor of the Senate autism bill, said he remains unconvinced and will continue pushing his version. He said the House bill has improved, but remains an unfunded recurring cost without a funding source. The KidCare provisions, he said, have never been vetted in the Senate. Even with new cost-cutting provisions that now appear in the bill, he said, it still will probably cost $5 million to $6 million per year.

Thursday night, negotiations over the dueling autism initiatives were ongoing, with the end of the legislative session looming today.

Reporter Catherine Dolinski can be reached at (850) 222-8382 or cdolinski@tampatrib.com

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