How Many Children Just Lost Coverage in Florida?

Over the past year, Florida Policy Institute has been sounding the alarm over the “looming tidal wave” of health care coverage loss in the Sunshine State that advocates have warned could coincide with the end of federal continuous coverage provisions. (During the pandemic, such provisions ensured that adults and children retained Medicaid benefits without having to re-enroll in the program.) Unfortunately, such fears have been confirmed. The post below was originally published by the Georgetown University Center for Children and Families "Say Ahhh!" health policy blog.

We just received a copy of Florida’s report to CMS on its first month of “unwinding” the Medicaid continuous coverage provisions for April and the data is alarming. Of the 461,322 people whose eligibility was checked, more than half — 54 percent or 249,427 people — were terminated.

Most of those terminated (82 percent) had their cases closed, not because they were determined to be ineligible (that was only about 10 percent i.e. 44,305 who were transferred to the Marketplace), but for procedural or “red tape” reasons (205,122).

This is extremely troubling and is similar to the scary numbers we saw in Arkansas last week where 80 percent of the terminations were for procedural reasons. A key difference though between Arkansas and Florida is, of course, that Florida has not expanded Medicaid to adults, so the coverage losses in Florida will be concentrated among children, parents and young adults. When governors see such large numbers of terminations of coverage for procedural reasons, they should pause the process and see what is going wrong. Are families actually getting the renewal packet? Are they having trouble getting through to the call center for help? Has their eligibility been properly assessed?

We have already heard numerous anecdotal reports of families in Florida finding out that their coverage was terminated when going in for an appointment and learning they have been terminated or erroneously terminated. Some will undoubtedly fall into the coverage gap because Florida has not expanded Medicaid. Among the nearly 250,000 being terminated from coverage in Florida was a little boy who had leukemia.

It’s hard to compare apples to apples here because states are prioritizing different groups first, and reporting data differently, but we saw far less concerning data from Arizona last week – where 17 percent were terminated in the state’s second month of unwinding. The first month of data from Arizona saw large losses amongst the Temporary Medical Assistance (TMA) population, which sort of makes sense as this is a time-limited category for parents who see their income rise due to earned income.

One thing we know for sure — because Florida is not an expansion state — is that the vast majority of the coverage losses will impact children, parents, young adults and new mothers. What we don’t know is how many of the 250,000 people who just lost coverage fall into these groups. We do know that children are very likely to remain eligible for Medicaid and less likely to have another source of coverage.

There is no question that some people are going to lose Medicaid because they no longer qualify in every state. But when we see numbers of this magnitude, especially where children are concerned, this is a matter of grave concern.

Joan Alker is the executive director of the Center for Children and Families and a research professor at the Georgetown McCourt School of Public Policy.

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