More than two years after Florida lawmakers voted to extend subsidized health coverage to tens of thousands of additional children, the expansion has yet to fully take effect. The KidCare eligibility increase, passed as SB 246 in 2023 and scheduled to launch on January 1, 2024, remains stalled as of spring 2026, leaving families in a coverage gap that was supposed to have closed.
The delay comes as a Kaiser Family Foundation analysis documents a national rise in the number of uninsured children, driven largely by states unwinding pandemic-era Medicaid protections. Florida, home to one of the largest populations of uninsured children in the country, now faces pressure on two fronts: a state law that has not been carried out and a federal mandate it may not be meeting.
What the law was supposed to do
SB 246 (with its House companion, HB 121) raised income eligibility limits for three KidCare programs, MediKids, Florida Healthy Kids, and the Children’s Medical Services Network, from 200% to 300% of the federal poverty level. For a family of four, that shift moves the cutoff from roughly $62,400 to about $93,600 in annual income, according to 2024 federal poverty guidelines. The Florida Senate Health Policy Committee’s bill summary confirmed the threshold change and the January 1, 2024, effective date.
The expansion targeted what health policy researchers call the “coverage cliff,” the income range just above Medicaid eligibility where families earn too much for free public insurance but too little to absorb commercial premiums and deductibles. Both the Florida House and Senate advanced the measure, and the governor signed it into law.
At the federal level, a parallel change reinforced the goal. Under the Consolidated Appropriations Act of 2023, the Centers for Medicare and Medicaid Services began requiring all states to provide 12 months of continuous eligibility for children under 19 enrolled in Medicaid and the Children’s Health Insurance Program, also starting January 1, 2024. The rule was designed to stop the cycle of children losing coverage mid-year because of paperwork lapses or small income fluctuations, a pattern long tied to delayed pediatric care and higher emergency department use.
Together, the state expansion and the federal continuous eligibility requirement represented the most significant structural change to Florida’s children’s health insurance framework in more than a decade. One policy widened the door; the other was meant to keep families from falling back through it.
Where the expansion stalled
Despite the clear legislative timeline, the Florida Agency for Health Care Administration, which oversees KidCare enrollment and Medicaid operations, has not fully implemented the higher income thresholds. As of May 2026, the agency has not released a public statement explaining the specific administrative or budgetary reasons behind the delay. No named state official has gone on the record to account for the gap between the law’s effective date and the program’s actual status.
“We have families calling every week who were told the income limits went up, and then they apply and get denied,” said Miriam Harmatz, executive director of Florida Health Justice Project, a legal advocacy organization that assists low-income families with public benefits enrollment. “The law is on the books. The money was appropriated. But the door has not opened.”
That experience has been echoed by pediatricians and enrollment counselors across the state. Dr. Lisa Gwynn, a pediatrician at the University of Miami and president of the Florida Chapter of the American Academy of Pediatrics, said the delay has had tangible consequences in her practice. “I see children who should qualify for subsidized coverage under the new thresholds but are stuck in limbo,” Gwynn said. “Their parents are making difficult choices between paying for a sick visit and paying rent.”
For households earning between 200% and 300% of the federal poverty level, the practical result is that a benefit the Legislature approved remains out of reach.
It is also unclear whether the delay puts Florida out of compliance with the federal continuous eligibility mandate. CMS has stated the requirement plainly, but the enforcement mechanism and any penalties for noncompliance have not been detailed in publicly available federal guidance. Whether CMS has contacted Florida about the issue, or whether the state has sought a waiver or extension, is not confirmed in available records.
The national picture sharpens the concern
Florida’s stalled expansion does not exist in isolation. Across the country, the unwinding of pandemic-era continuous Medicaid enrollment led to millions of people, including children, losing coverage through administrative disenrollment. KFF’s tracking of the unwinding found that a significant share of those dropped from rolls lost coverage for procedural reasons rather than because they were actually ineligible.
Nationally, the share of children without health insurance had fallen to historic lows during the pandemic, when states were required to keep enrollees on Medicaid rolls as a condition of receiving enhanced federal funding. As that requirement ended, uninsured rates among children climbed. According to KFF’s analysis of Census Bureau data, the uninsured rate among children rose from 5.0% in 2022 to 5.4% in 2023, representing roughly 400,000 additional children without coverage nationwide. Florida, which has the third-largest child population in the nation, was already among the states with higher-than-average rates of uninsured children before the unwinding began.
The KFF data operates at the national level and does not isolate Florida’s KidCare delay as a direct cause of rising uninsured numbers in the state. But the broader trend is directionally consistent: when expansions stall and administrative barriers persist, children fall through the cracks.
What affected families should know
For parents navigating the system now, the most concrete step is to check eligibility through the Florida KidCare website or by calling the program directly, even if they have previously been told their income is too high. Children already enrolled in MediKids or Florida Healthy Kids should remain covered under existing rules, and the federal continuous eligibility requirement, if fully enforced, should prevent mid-year coverage losses for those under 19.
Families whose income falls between 200% and 300% of the federal poverty level should apply and keep records of their attempts. Documenting a denied or delayed application could matter if the state faces federal enforcement action or later offers retroactive enrollment to families who were eligible under the law but unable to access benefits.
Why AHCA’s silence leaves Florida families in limbo
The gap between what Florida’s law promised and what families have received is not a matter of political interpretation. It is a matter of documented legislative action and a federal regulation that have not translated into coverage on the ground. The Legislature voted. The governor signed. The federal deadline arrived. And yet, as of spring 2026, the expansion remains incomplete.
Until state officials explain the delay and publish clear timelines for bringing KidCare into line with both state statute and federal requirements, Florida’s low- and moderate-income families are left navigating uncertainty instead of the stability that continuous, affordable children’s health coverage was designed to provide.
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*This article was researched with the help of AI, with human editors creating the final content.
