A federal judge Wednesday declared Florida's health care system for needy and disabled children to be in violation of several federal laws, handing a stunning victory to doctors and children's advocates who have fought for almost a decade to force the state to pay pediatricians enough money to ensure impoverished children can receive adequate care.

In his 153-page ruling, U.S. Judge Adalberto Jordan said lawmakers had for years set the state's Medicaid budget at an artificially low level, causing pediatricians and other specialists for children to opt out of the insurance program for the needy. In some areas of the state, parents had to travel long distances to see specialists.

The low spending plans, which forced Medicaid providers for needy children to be paid far below what private insurers would spend and well below what doctors were paid in the Medicare program for a more powerful group, elders amounted to rationing of care, the order said.

"This is a great day for the children in this state," said Dr. Louis B. St. Petery, a Tallahassee pediatrician who is executive vice president of the Florida Pediatric Society and who helped spearhead the suit. "This action was taken because we found that children weren't being treated properly if they were on Medicaid. Our position as pediatricians," he added, "is that children do not choose their parents. They don't have a choice to be born into a rich family or a poor family.

"We feel all children are of equal value."

The three state agencies named in the suit authored a short statement Wednesday afternoon: "The Judge's outdated observations pertain to a Medicaid program that no longer exists. Florida's new Statewide Medicaid Managed Care (SMMC) program is cost-effective and a working success." The statement was issued by the Agency for Health Care Administration, or AHCA.

The low billing rates, Jordan wrote, exacerbate a long-standing problem: There is a shortage of pediatricians overall. "The shortage gives pediatricians the ability to treat higher paying patients and either not treat, or limit, the number of Medicaid patients they do treat," Jordan wrote. "The shortage of pediatricians in rural areas is especially acute."

Enrollment in the Medicaid program increased from 1.2 million in 2005 to 1.7 million in 2011 though the number of primary care doctors for children apparently has not risen at all, he said.

Among Jordan's findings:

Almost 80 percent of children enrolled in the Medicaid program "are getting no dental services at all."

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Florida's health care system for needy and disabled children violates federal laws, judge rules