Poor policy design and under-investment in Florida’s safety net should never prevent a working parent from accepting a raise and building a better life for their family, whether that raise comes through a better job opportunity or by way of an amendment to the state constitution. Florida policymakers can address the benefits cliffs by supporting smart policies and bold investments in children and families.
With nearly 70 percent approval in the polls, there is a significant probability that voters will pass Amendment 2, gradually raising Florida’s minimum wage from $8.56 to $15 per hour by 2026. Florida Policy Institute’s recent analysis shows that this will benefit more than 1 in 4 Floridians, as well as boost the economy as working people spend that additional pay locally--bringing demand back to businesses and sales tax revenue back to the state.
One consideration raised by community advocates that is worth exploring is that raising the minimum wage, and rising wages overall, could steepen the so-called “benefits cliff.” A benefits cliff happens when individuals who receive public benefits start earning more income, but still not enough to make up for the loss of benefits as their new pay pushes them over eligibility thresholds. Child care vouchers, the Supplemental Nutrition Assistance Program (SNAP), Medicaid, and Temporary Assistance for Needy Families (TANF) are some of the most relevant programs to this discussion. However, there are common-sense changes state leaders can make to ensure fiscal stability for Floridians struggling to make ends meet.
In terms of Medicaid, it is unlikely that raising the minimum wage would result in an abrupt disruption of benefits for working Floridians. Florida has one of the nation's lowest Medicaid income limits — $6,924 annually for a three-person family — just 31% of the federal poverty level. So, while some families could lose Medicaid with a minimum wage increase, a benefits cliff is less likely, as the corresponding income boost would put Floridians above the poverty level, enabling them to afford employer-sponsored insurance or insurance through the Affordable Care Act (ACA) marketplace. The ACA marketplace provides premium tax credits and cost-sharing subsidies, so families with low and moderate incomes can purchase health insurance. An added benefit: the state would no longer have to pay its share of Medicaid coverage for those families transitioning to marketplace coverage.
Moreover, a minimum wage boost along with Medicaid expansion would eliminate the existing benefits cliff that more than 800,000 Floridians caught in the "coverage gap" currently face. People in the coverage gap have income too high to qualify for Medicaidunder Florida's current Medicaid program, but they do not make enough to get subsidies to purchase insurance through the ACA marketplace. Again, the state could save money through by substituting new federal expansion dollars for state funds currently supporting services like mental health and corrections.
Participants in SNAP are also less likely to face a benefits cliff due, in part, to smart policy choices the state has made about eligibility criteria. By design, SNAP allotments in Florida decline gradually instead of stopping abruptly when a family’s income increases. This is because SNAP allows for participants to work by using a 20 percent deduction for earned income, which reduces SNAP benefits by only 24 to 36 cents per additional dollar earned. This helps to reduce a “cliff” effect. But even more important is the fact that Florida permits families to have incomes of up to 200 percent of the federal poverty level -- rather than 130 percent as ordinarily required under federal law -- before they lose SNAP eligibility altogether. Instead of pushing out families who get raises at work that wouldn’t make up for the loss in benefits, Florida’s SNAP program is explicitly designed to accommodate families whose income remains too low to put food on the table for the entire month.
State lawmakers could improve Florida’s child care voucher program by taking some policy ideas from SNAP.
Families must have income under 150 percent of the poverty threshold to initially qualify for Florida’s School Readiness program, which provides child care vouchers to working parents. Once a family participates in the program, they retain eligibility until their income exceeds 200 percent of the poverty level, which allows for some wiggle room. However, once at this threshold, the fiscal drop-off is steep, as a family loses these vouchers entirely, rather than in a graduated manner like SNAP. Moreover, these vouchers are valuable, but often not enough, as most families end up paying “overage” charges for their child care provider for the difference between voucher value and true cost of child care. (Center-based care for a toddler in Florida averages $8,618, annually.)
Unlike the SNAP program, School Readiness vouchers are not an “entitlement,” meaning they are not a guarantee for all eligible people. In fact, demand for child care vouchers far outstrips supply; as it stands, less than half of eligible Florida families are lucky enough to receive them. Despite a recent infusion from the federal CARES Act, stubbornly long wait lists for child care vouchers persist across Florida. Indeed, in light of recent announcements from major corporations like Disney and Target of wage increases to $15 an hour, the Early Learning Coalition (ELC) of Orange County has identified that more funding for School Readiness and a reevaluation of the eligibility requirements are in order.
Acknowledging this need, the Legislature included language in its last two budgets allowing local ELCs to use a portion of their funding to allow initial eligibility for families making up to 200 percent of the poverty level ($43,440 for a single parent with two children). This pilot should be expanded and coupled with a graduated fee scale for families to eliminate a severe cliff for Florida’s School Readiness program. Additionally, without a significant investment to increase School Readiness funding so that more eligible families can participate, this program will continue to only assist a sliver of eligible families. This infusion would also help to revitalize the child care industry in Florida, which is distressed due to pandemic disruption.
As for TANF, the state’s meager payment standard and uncertain funding for transitional services contribute more to a family’s fiscal “cliff” than phaseout eligibility. On the one hand, Florida’s TANF program has generous income disregards that slowly phase out families’ benefits over time. For families who work, Florida disregards the first $200 of earned income plus half of the remainder.
But Florida’s inadequate TANF payment standard, which has not increased since 1992, keeps families out of the program for that reason alone. Because countable net income cannot be higher than the TANF payment standard, many families are ineligible for assistance, even with Florida’s generous disregards. For a three-person family, household income, after disregards, cannot exceed $303 a month.
Former TANF participants who lose assistance due to earnings are, however, potentially eligible for transitional benefits while they get their footing in the workplace. In Florida, families with income at or below 200 percent of the poverty level who lose TANF due to increased earnings may be eligible for up to two years of transitional transportation, child care, and education and training services — but only if funds are available. Transitional Medicaid may be available for up to 12 months, although income in the second six months must not exceed 185 percent of the poverty level.
State lawmakers, by enacting the above policy changes, can help ensure the financial health of families amid increasing wages.
American Rescue Plan Act Changes. The American Rescue Plan Act of 2021 extended PEUC and PUA benefits through the week ending September 6, 2021. It also increased the maximum duration of PEUC benefits ($300 a week) to 53 weeks and the maximum duration of PUA to 79 weeks. Although PEUC and PUA did not end until September 6, 2021, Florida withdrew from the Federal Pandemic Unemployment Compensation Program (FPUC) effective June 26, 2021. FPUC provided persons who were out of work due to COVID-19 with an additional $300 a week in unemployment insurance.
Reemployment Assistance weeks reverted to 12 effective January 1, 2022. DEO determines the maximum number of weeks available to RA claimants based on a statutory formula that looks at the average unemployment rate for the most recent third calendar year quarter (i.e., July, August, and September). Based on the downturn in unemployment, the maximum number of weeks for RA reverted to 12 effective January 1, 2022.
RA work-search and work registration requirements reinstated on May 30, 2021. Persons filing an application for RA benefits beginning March 15, 2020, are not required to complete work registration in Employ Florida through May 29, 2021. In addition, work search requirements for individuals requesting benefits for the weeks beginning March 15, 2020, were also reinstated on May 30, 2021.
RA biweekly reporting requirements reinstated. Although previously waived, biweekly reporting was reinstated effective May 10, 2020. DEO’s guide to claiming weeks is here.
Mobile app deployed. DEO has deployed a mobile app for RA applications.
DEO announces extended benefits. DEO announced implementation of Extended Benefits (EB).
Resources and guidance. For a list of resources and guidance from the United States Department of Labor on unemployment insurance and COVID-19, go here.
For DEO’s “Reemployment Assistance Frequently Asked Questions and Additional Resources,” updated 12/30/2020, go here.
For DEO’s latest claims data, go here.
DCF opens offices. DCF has reopened its brick-and-mortar storefronts, which were previously closed due to coronavirus.
DCF adds call center numbers. DCF has added a call center number for Monday through Friday, from 7 a.m. to 6 p.m. Call center numbers now include 850-300-4323, 866-762-2237, or TTY 1-800-955-8771.
Certification periods extended by 6 months only through August 2020. Certification periods for cash, food and medical assistance were extended by 6 months for individuals and families scheduled to recertify in April through August 2020. FNS’ approval of the SNAP extension for August is here. However, effective September 1, 2020, SNAP, TANF and Medicaid recertifications have been reinstated, although DCF says that no one will lose Medicaid due to recertification.
DCF allows phone interviews. Phone interviews are now being used for TANF cash and SNAP food assistance.
Mandatory work requirements suspended only through May 2021. Under a directive from Governor DeSantis to waive work requirements for safety net programs, DCF waived work requirements for individuals participating in the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) through May 2021. To do this, DCF explains that it partnered with the Department of Economic Opportunity to apply “good cause” statewide for TANF and SNAP recipients who would otherwise be subject to participation in mandatory work requirements as a condition of receiving those benefits. Through May 2021, persons who were sanctioned in the past due to work requirements will be able to reapply and participate in SNAP or TANF again.
Work requirements were reinstated effective June 1, 2021.
Emergency allotments (EA) ended. DCF automatically supplemented SNAP allotments of current recipients up to the maximum for a household’s size for July 2021. However, EA was discontinued beginning August 1, 2021.
The SNAP benefits increase by 15 percent ended in October 2021. Floridians who participate in SNAP to put food on the table will receive a temporary 15 percent supplement to SNAP under COVID relief passed by Congress and extended by the American Rescue Plan Act through September 2021.
FNS permanently increases SNAP through revamp of the Thrifty Food Plan. Effective October 2021, FNS has mandated a permanent increase to SNAP through a revamp of the Thrifty Food Plan. DCF says that the increase amounts to about 6% for Floridians.
Time limits suspended. SNAP time limits are suspended during the COVID-19 public health emergency. No one in Florida should be barred from SNAP due to time limits, even if they exhausted their time limit in the past.
Florida granted waiver to allow families to purchase groceries online. DCF has been granted a federal waiver to permit the State of Florida to launch a pilot project statewide effective April 21, 2020, that allows families to purchase groceries online with their Electronic Benefit Transfer (EBT) card instead of going into stores.
No Medicaid terminations from March 2020 through the end of the federal public health emergency. The national public health emergency has existed since January 27, 2020 and has been renewed by the Secretary of the U.S. Department of Health & Human Services in 90-day increments since that time. The most recent renewal is effective January 16, 2022.
On March 31, 2020, AHCA alerted providers and DCF posted on the ACCESS website that:
Redetermination/recertification times are reinstated. As of October 1, 2020 AHCA's website is alerting recipients that the Department of Children and Families is now mailing letters for case reviews to check if a household is still eligible for Medicaid and/or Medically Needy. AHCA is urging people receiving these letters to take steps now to re-apply. But note, Medicaid coverage will not end during the COVID-19 Public Health Emergency. In January 2021 DCF conducted one-year “automated renewals” for people whose sole income is social security and SSI and are enrolled in an SSI-related Medicaid program (e.g., MEDS/AD, Medically Needy and Medicare Savings Programs). People getting VA income were not included in the automated renewal.
Extended application time. Effective with applications filed in February 2020, the time for submitting documentation required to process an application is extended for 120 days from the date of the application and eligibility will still be effective the first day of the month the application was received. Effective July 1, 2021, this policy has been rescinded. Medicaid applications submitted on or after July 1, 2021 may be denied on the 30th day after application or the day after verification information is due. Applications filed prior to July 1, will be allowed 120 days to provide requested verification to establish Medicaid eligibility.
Exclusion of additional unemployment payments in determining eligibility. The $600/week of additional unemployment insurance payments under the CARES Act will not be counted as income in determining Medicaid eligibility. (However, these payments will be counted as income in determining marketplace subsidy calculations.)
Coverage of Medicaid services during the state of emergency
COVID-19 Vaccines for Medicaid Enrollees. In an executive order published March 16, 2021 Governor DeSantis revised the vaccine distribution plan, which applies to the general public including Medicaid enrollees, to lower the age requirement to 40 effective March 29, 2021 and then effective April 5, 2021 all Floridians are eligible to receive any COVID-19 vaccination approved by the Food and Drug Administration.
Medicaid enrollees eligible to receive the vaccine may visit myvaccine.fl.gov to find a location distributing the vaccine and to schedule an appointment.
On March 12, 2021, AHCA published instructions for Medicaid enrollees on how to obtain Medicaid transportation once they have scheduled an appointment for a vaccine. AHCA states: "Florida Medicaid will take you to get the COVID-19 vaccine at no cost. All you need to do is set up a time to get your vaccine. Next, let your Medicaid plan know you need a ride and they will take care of the rest. If you are not enrolled in a plan, call the Medicaid Helpline at 1-877-254-1055 to find out the name and phone number for a transportation service."
The state has also recently launched a new email system to help bring COVID-19 vaccines to homebound seniors. Seniors will be able to sign up to have the vaccine come to them by emailing a request to HomeboundVaccine@em.myflorida.com.
AHCA has posted Medicaid Alerts and FAQs providing more detail on Medicaid service changes in response to COVID-19. They address a wide range of topics including, but not limited to: telemedicine guidance for medical, behavioral health, and early intervention services providers; long-term care provider network flexibilities allowing more types of providers to deliver specified long term care services; and continuity of care for adult day care center enrollees during the time these centers are closed.
AHCA is loosening coverage restrictions for behavioral health services. Effective May 5, 2020, all prior authorization requirements for mental health or substance use disorder treatment are waived and service limitations (frequency and duration) are lifted. For behavioral analysis services, current authorizations will be extended through an "administrative approval process" which does not require providers to reassess beneficiaries currently getting services. Effective July 1, 2021 service limits will be reinstated for behavioral health services and effective July 15, 2021 Medicaid prior authorization requirements will be reinstated for behavioral health services.
Per a May 29, 2020 provider alert, during the state of emergency AHCA will be reimbursing providers for telemedicine well-child visits provided to children older than 24 months through age 20. Providers are directed to actively work to schedule follow-up in-person visits to administer immunizations and other physical components of the exam which cannot be accomplished through telemedicine.
The public charge rule will not be applied to immigrants’ use of Medicaid benefits for COVID-19 testing and treatment.
Coverage of home and community-based waiver services (HCBS) - In response to the public emergency, Florida obtained approval from the federal government to make changes in HCBS waiver programs, including the Long Term Care and Developmental Disabilities programs. The changes are effective retroactively from January 27, 2020 to January 26, 2021. Details can be found here. They include, but are not limited to:
Note on COVID-19 testing, treatment, and vaccines for the uninsured. Florida has not opted to receive 100 percent federal Medicaid funding for COVID-19 testing of people without health insurance. Under the 2021 American Rescue Plan Act this option has been expanded to cover COVID-19 treatment and vaccines for the uninsured as well. Since the state has not taken up this option Floridians must look to an uneven patchwork of free testing, treatment, and vaccine resources scattered around the state. AHCA advises that uninsured people may receive free testing from their county health department or a federally qualified health center and that “many communities provide testing for free for individuals who do not have insurance. Please [click here] to find a test site in your area. Uninsured individuals should ask before the test whether testing is free of charge." There are no state agency instructions on where uninsured people can receive free treatment. However, more information on possible sources for free treatment is available here.
Residency proof no longer required at some vaccine sites, “paving the way for migrants.” - On April 29, 2021 Surgeon General Rivkees issued a new public health advisory specifying that COVID-19 vaccines are available to “a Florida resident” or someone “who is present in Florida for the purpose of providing goods or services for the benefits of residents and visitors of the State of Florida.” This new policy applies to all state-run and federally supported vaccination sites. It rescinds an advisory issued in January that had restricted vaccinations to people who could show proof of Florida residency
2021 unemployment compensation claimants can access free or reduced cost health insurance through the ACA marketplace. The Affordable Care Act (ACA) Marketplace was re-opened in February 2021 to give people who need health insurance a new “special enrollment" opportunity to get covered. The 2021 American Rescue Plan eliminated or vastly reduced premiums for many people with low or moderate incomes.
Starting July 1, 2021, people who received or have been approved for unemployment compensation for any week beginning in 2021 can access free or reduced cost comprehensive health insurance plans through the ACA marketplace. This benefit is available regardless of someone's current income. To get this benefit, people must enroll in the marketplace no later than August 15, 2021. For help with enrollment, contact Covering Florida at 877-813-9115.
School children in distance learning still eligible for free or reduced cost meals. Students in distance learning for 2020-21 can still receive school meals through the National School Lunch Program if they are eligible. The student or parent/guardian may pick up meals at the school but should contact their school for more information.
For a list of current child nutrition program waivers for Florida from USDA, go here.
Congress allows increased fruit and vegetable benefits. At present, WIC provides $9 for children and $11 for women monthly for fruits and vegetables. The American Rescue Plan Act makes funding available for a four-month increase in the benefit of up to $35 monthly, if a state chooses to do so.
DOH attains waiver allowing remote issuance: Department of Health (DOH) obtained a waiver of the requirement that participants pick up their EBT cards in person at recertification or during nutritional education appointments.
WIC participants allowed to substitute certain food. Under a waiver from USDA, WIC participants in Florida are allowed to substitute milk of any available fat content and whole wheat or whole grain bread in package sizes up to 24 oz. when 16 oz. packages are unavailable.
USDA waived physical presence requirements: Although the scope and logistics are unclear at this time, USDA has given DOH permission to waive the requirement that persons be physically present at each certification or recertification determination in order to determine eligibility under the program through May 31, 2020.
USDA extends certification periods through May 31, 2020, for some participants.
For a list of current WIC waivers for Florida from USDA, go here.
HHS provides guidance. HHS has issued guidance on the flexibilities in TANF to respond to COVID-19.