Tampa Republic

Nearly 250k Floridians lost Medicaid coverage in the first month of redetermination due to bureaucratic hurdles

TAMPA, FL – Rep. Kathy Castor (FL-14) today led all Congressional Florida Democrats in urging Governor Ron DeSantis to immediately protect  Floridians from costly medical bill and pause procedural dis enrollments of Floridians currently covered by Medicaid. The delegation’s letter comes after 52 organizations across the state called for a pause on the state’s Medicaid redetermination process, citing concerns that eligible Floridians have had their coverage terminated due to procedural, or “red tape,” issues. 

“If the Florida redetermination period continues at its current trajectory, we will see an unnecessary and harmful increase in uninsured children, postpartum parents, individuals amid complex treatment, and other others, including many that may remain eligible for coverage,” the Lawmakers wrote.

They continued, “Florida’s state objectives for redetermination are to ensure the continuity of Medicaid coverage for eligible individuals, promote access to alternative coverage, prioritize exceptional customer service, and enhance operational efficiencies. We believe pausing procedural disenrollments will allow the state to reassess its redetermination process, make improvements, and meet those objectives before too many Floridians lose their health coverage.”

To receive federal relief funds related to the COVID-19 Public Health Emergency (PHE), the Congress required states to provide continuous health care coverage through Medicaid and pause disenrollments. As a result of the 2023 Consolidated Appropriations Act, the continuous coverage requirement ended on March 31, 2023, and individuals will undergo Medicaid renewals over a twelve-month period. In the first month of the redetermination period for Medicaid beneficiaries, Florida’s DCF terminated coverage for 249,426 individuals—82% of which were terminated for procedural reasons, not ineligibility.

Full text of the delegation’s letter is available here and below.

The Honorable Ron DeSantis
Governor                                                                            

State of Florida                                              

The Capitol                                                                                              

400 S. Monroe Street                                                                                                          

Tallahassee, FL 32399 

RE: Pause of Medicaid Coverage Terminations to Ensure Floridians’ Access to Health Coverage

Dear Governor DeSantis:  

Due to the high number of Floridians being disenrolled from Florida Medicaid without an indication of subsequent health coverage, we urge you to pause procedural disenrollments immediately. In the first month of the redetermination period for Medicaid beneficiaries, Florida’s Department of Children and Families (DCF) redetermined eligibility for 461,322 individuals, and 249,427 individuals were terminated from the program – a high 54% so far. According to data that the state submitted to the Centers for Medicare and Medicaid Services, 205,122, or 82%, of the terminated individuals were for procedural reasons.[1] The disenrollment rate is incredibly concerning as the rate is much higher than termination rates in other states. Florida also reported a large number of individuals whose cases remained pending. If the state moves forward as planned, the system will become too stressed, throwing more families into uncertainty and facing higher costs.  

We are particularly concerned about the high potential for children to lose their Medicaid coverage and become uninsured during the redetermination period, even while they remain eligible.[2] About half of the enrollment growth in Florida Medicaid during the COVID-19 pandemic is attributable to children, and over 65% of Florida’s children were covered by Medicaid or CHIP at the start of the redetermination period.[3] If the Florida redetermination period continues at its current trajectory, we will see an unnecessary and harmful increase in uninsured children, postpartum parents, individuals amid complex treatment, and other Floridians, including many that may remain eligible for coverage.  

Along with the alarming data, we have heard troubling reports from local partners, navigators, and community assisters in the state. In Florida’s Medicaid Redetermination Plan, the state said that DCF would not prioritize reviews of individuals who have used Medicaid benefits and services in the last 12 months or children with complex medical conditions, but we know that both scenarios have tragically happened in the first month of redetermination.[4] [5] [6] We have learned that families are waiting hours to speak to someone at the call center and have received confusing or contradictory information and notices that do not explain why they were terminated. Florida has indicated it will take 12 months to complete their Medicaid redetermination. Still, DCF reviewed 12% of beneficiaries in April—there is time to slow down and assess the redetermination process.[7]

We respectfully ask you to provide written responses to the following questions:

1. Please provide a more detailed breakdown of the 249,427 individuals who were disenrolled for procedural reasons.

1. How many individuals are children?

3. How many individuals have received services or utilized Medicaid benefits in the last 12 months?
4. How many individuals received multiple forms of communication? 
5. Are parents being told that even though they may fall into the coverage gap, their children likely remain eligible for Medicaid?

1. Does the state plan to increase the number of beneficiaries renewed ex parte by partnering with other state agencies or Medicaid plans?
2. Does the state plan to increase the number of beneficiaries renewed ex parte by partnering with other state agencies or Medicaid plans?

We know that the end of the Medicaid continuous coverage period is the most significant health coverage event since the creation of the Affordable Care Act, and we understand that DCF employees are faced with an enormous undertaking. However, any gap in health coverage can be devastating and potentially exposes people and families to high burdens of medical debt and less access to needed care. Florida must use every tool at their disposal to prevent a mass disenrollment of individuals, particularly while they have enhanced federal matching funds to help cover the costs of the transition. And since two-thirds of Florida’s children are insured through Medicaid, the “unwinding” is critical to families and the providers who serve them.

Florida’s state objectives for redetermination are to ensure the continuity of Medicaid coverage for eligible individuals, promote access to alternative coverage, prioritize exceptional customer service, and enhance operational efficiencies. We believe that pausing procedural disenrollments will allow the state to reassess its redetermination process, make improvements, and meet those objectives before too many Floridians lose their health coverage and suffer negative consequences. 

Original source can be found here.