A federal judge has ruled on Wednesday that the health care system for the impoverished children in Florida is marred by problems that violate U.S. laws.
Judge Adalberto Jordan found that nearly 2 million children who rely on the Florida Medicaid program do not receive the necessary care stipulated by federal law.
In a 153-page decision, Jordan said the state's low Medicaid budget caused healthcare service providers for impoverished children to be paid way below than what they would receive from private insurers. One specialist, for instance, testified that Medicaid would only pay about $85 for a medical service that costs an average of $138.
As a result, pediatricians and other children specialists opt out of the government insurance program for the needy exacerbating the shortage of pediatricians.
"In discharging its responsibility to set physician reimbursement rates, AHCA (the state Agency for Health Care Administration) does not consider whether the reimbursement rates are sufficient to ensure that children on Medicaid have access to health care services equal to that of other children in the general population," Jordan wrote.
Jordan wrote that because of shortage in the number of pediatricians, children's specialists get to treat patients who can pay more but may either choose not to treat or choose to only accommodate a small number of Medicaid patients. The problem is especially more acute in rural areas with some parents being forced to travel long distances in order for their children to see a specialist or wait for a long time to avail of healthcare services.
The judge also found that 79 percent of Medicaid enrolled children do not get dental services. Because of the very low doctor payments, state health regulators also left out a third of the children on Medicaid without preventative care regardless of requirements mandated by federal law.
Federal law were likewise found to be violated by switching needy children from one provider to another without the knowledge and consent of their parents and by kicking out thousands of children from the Medicaid per year at times simply because of bureaucratic error with about 25,000 children under the age of 5 taken out of the program between 2003 and 2007 before they received a year of insurance. Only a small number of needy children in Florida also received blood screening for lead.
The ruling marks the victory of physicians and children's advocate embroiled in nearly a decade of legal battle to pressure the state into paying pediatricians sufficient amount of money to guarantee that needy children can be given adequate care.