Groups Call for ‘Pause’ on Medicaid Redetermination Process After Florida Sees Tidal Wave of Coverage Loss

Fifty-two organizations today called for a pause in the state’s Medicaid redetermination process, which — in the first month following the end of federal “continuous coverage” provisions — has resulted in 250,000 Floridians having their coverage terminated, 82 percent of whom had their cases closed for procedural or “red tape” reasons, not necessarily because they were no longer eligible.

Health care advocates have been sounding the alarm that a massive health care coverage loss event could coincide with the end of Medicaid continuous coverage protections, which ensured that children and adults were able to retain their benefits during the pandemic without having to re-enroll. These fears were confirmed after data from April 2023 showed that 54 percent of the 461,322 people whose eligibility was checked were terminated.

In a letter to Gov. Ron DeSantis and agency heads at the Department of Children and Families and Agency for Health Care Administration, the groups expressed concern about those with serious conditions who will continue losing access to life-saving treatments, along with Floridians who risk substantial medical debt or even bankruptcy as a result of coverage loss.

Two of the groups who signed onto the letter — Florida Policy Institute and Florida Health Justice Project — along with the Northeast Florida Healthy Start Coalition’s Maternal & Child Health Policy & Research Center and Georgetown University Center for Children and Families, shared concerns about Florida’s Medicaid unwinding process at a press conference this morning.

Since Florida remains one of only a handful of states that has not expanded Medicaid, most of the coverage losses will impact children, parents, young adults and new mothers, as noted in a recent Georgetown University Center for Children and Families blog post.

Erica Monet Li, policy analyst at Florida Policy Institute, said: “One of the main concerns is that this is just the beginning. If 82 percent of those who were disenrolled are losing coverage for procedural reasons that we cannot fully determine at this point, we owe it to Floridians who use Medicaid as their primary form of health care coverage to figure out what is going on. We also want to keep in mind that this is largely going to impact Florida’s children, who as of March, made up over 50 percent of our Medicaid program.”

Miriam Harmatz, director of advocacy and founder at Florida Health Justice Project, said: “In addition to the large number of procedural terminations, most of whom are likely to be children who are still technically eligible, we’re hearing from clients who should not have been in the state’s first group of terminations because they are currently using Medicaid services, including children with complex medical needs. And these cases are raising a number of procedural concerns — from lack of required notices to notices that fail to provide an appropriate reason for termination or any relevant information on how and where to appeal.”

LaVonne Brown, DrPH, center director at the Maternal & Child Health Policy & Research Center, an initiative of the Northeast Florida Healthy Start Coalition, said: “The key to preventive medicine is that it has to start in childhood. Therefore, Medicaid unwinding, if there is a gap of services, will further delay health services to Northeast Florida’s underserved population. It will worsen the health status of many children and their families — the net result will be a higher cost to health care for the country in the long run and worse outcomes for these populations.”

Joan Alker, executive director at Georgetown University Center for Children and Families and a Medicaid expert who has been tracking the Medicaid continuous coverage wind-down nationwide, said: “Florida’s governor should commit to data transparency and engage all available resources to make sure Florida’s already high child uninsured rate doesn’t go even higher.”

The letter notes that pausing the unwind process will enable the state to confirm that the people losing coverage are no longer eligible, and it will allow time for those who are no longer eligible to be connected with alternative forms of coverage where possible.

Groups Call for ‘Pause’ on Medicaid Redetermination Process After Florida Sees Tidal Wave of Coverage Loss

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

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