State projects 1.75 million Floridas may lose Medicaid coverage as pandemic-era law expires

More than 1 million Floridians could lose Medicaid coverage this year as the state seeks to return enrollment to pre-pandemic levels.

The state can begin enrolling people who are no longer eligible for the program on April 1. It would be the first time the state has been able to do so since 2020, when the federal government mandated that people enrolled in Medicaid have continuous coverage. Since then, enrollment in the Florida program has nearly doubled, with more than five million recipients as of last month.

Provision in the spending bill Late last year has changed thatallowing states to begin removing beneficiaries who are no longer eligible this spring.

States that do so will lose access to some federal matching funds. To help cover the cost of providing continuous coverage throughout the pandemic, Congress has boosted Medicaid matching funds by 6.2%. That will drop to 5% starting April 1 and will continue to drop gradually every few months this year.

Officials with the Florida Department of Children and Families say they are It has already identified about 900,000 cases of people who no longer qualify for state Medicaid, due to changes in income, age, or other factors. Some of these people may qualify for other health coverage, such as Florida KidCare.

The main concern of health policy experts like Joanne Alker, executive director of the Center for Children and Families at Georgetown University, is the people who remain eligible but who might slip through the loopholes if bureaucratic problems arise.

She cited as an example: “They can’t get to a state call center if it’s inundated with calls for help with the application, they don’t get the message in the mail about this renewal and they lose coverage.” “And maybe a parent will come to the pharmacy and try to extend their child’s asthma prescription and the pharmacist will say, ‘Oh you’re not insured,’ and that’s what they find out.”

DCF estimates there are another 850,000 Medicaid recipients who have not responded to requests for updated information and are at risk of losing coverage. Some may have taken out other health insurance in recent years, but Alker speculates that many may not have received or understood the connection.

These estimates are based on data as of December 2022, provided by the federal government Publication of new poverty guidelines That was raised this year to account for inflation. It’s unclear how those will affect the group of at-risk beneficiaries, but Alker says it could mean thousands more families are eligible to keep their Medicaid.

She’s particularly concerned about children in Florida, since they make up the largest portion of Medicaid beneficiaries in the state. Most will likely still be eligible for coverage this year, so Alker says it’s imperative the state ensures they don’t experience any disruptions to care due to administrative issues.

“If the state sees these kinds of coverage losses happening, it’s time to hit the pause button,” she said.

Division of Children and Families, which handles Medicaid eligibility determinations, I recently posted a plan for how to proceed with renovations. Officials say they will phase the process out over 12 months. The Health Care Administration Agency actually administers Medicaid services.

Alker says it’s important for the state to take its time with this and provide resources to help families get through renovations. This includes conducting multilingual outreach for residents with limited English proficiency and partnering with organizations that have trusted relationships in the communities. It also includes having enough staff in call centers to handle the expected influx of calls.

DCF officials say they have beefed up staffing at call centers and will offer people-focused messaging in English, Spanish and Haitian Creole.

How do I get help

Alker stressed that registrants must ensure the accuracy of their contact information on file with the state, especially those who suffer from precarious living conditions. People should also look out for messages from the state in the coming months.

DCF’s Office of Economic Self-Sufficiency has a customer call center that residents can reach at 850-300-4323. They can also call 711 for Florida Relay or TTY 1-800-955-8771.

Primary care physicians, health clinics and operators of Medicaid managed care plans are also good resources to help, Alker said.

The Georgetown Center for Children and Families published a report last year which found that Florida has a large number of “red flags” in its health care system It could lead to disruptions to care as pandemic requirements are being phased out especially compared to other countries. Alker said she’s pleased to see some of the commitments the state has made in its plan for Medicaid selections, but said this spring will be the real test.

“So there are a lot of concerns here at all across the country, but Florida especially has reasons to be concerned and that’s concerning because Florida already has one of the highest uninsured rates, and this process can make it much worse especially for children,” she said.

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