Over half of Floridians who have lost Medicaid coverage did so because of procedural reasons and not because they were ineligible, according to an analysis from the Georgetown University Center for Children and Families.
The Georgetown center, and several healthcare policy groups, discussed the state’s handling of the Medicaid redetermination process following the end of the COVID-19 public health emergency, according to a press call Tuesday. After that, tens of thousands of Medicaid recipients lost their health care.
“Florida already has one of the highest child uninsured rates in the nation, and the state’s mishandling of this unwinding is likely to make a bad situation worse,” said Joan Alker, executive director at Georgetown’s center. “As children head back to school, we know that gaps in coverage are a big problem.”
She added: “We’ve heard numerous stories of children having to forego needed treatments because they are disenrolled from Medicaid and have no coverage. So, it’s certainly time for the governor to hit pause and get to the bottom of why so many Floridians are losing coverage for procedural reasons, especially for children.”
Alker also said in the press call that “We hear that the federal government is investigating a problem. We don’t know which states have this problem. But it’s possible that Florida has this problem. And this is a systemic problem with the automatic renewal process…and that’s where states have to check available income data to try to requalify families.”
Meanwhile, The Florida Policy Institute, in a release after the press call, said that the group “also brought attention to a recent letter from the Centers for Medicare and Medicaid Services (CMS) to Florida’s Agency for Health Care Administration Secretary Jason Weida that outlines some possible violations by the state in its Medicaid redetermination process. Broadly, it seems that Florida is on track to receive federal corrective actions, which could include a pause in the process or financial ramifications.”
However, policy groups are not the only ones unhappy with the developments in Florida, including more than 128,000 children losing coverage, long call center wait times and long application processing time for applying for and renewing Medicaid.
“Excessive call center wait times and call abandonment rates may signal barriers to the opportunity to complete an application or renewal for Medicaid … telephonically,” according to the letter.
Also, “Persons of color are less likely to have broadband or internet access, or transportation or jobs that permit the time and access needed to meet with Medicaid enrollment staff in person, and therefore may rely more on call centers.”
Furthermore, CMS will follow up on changes the Florida healthcare agency might impose to solve the problems raised in the letter.
Florida News Connection
Health policy experts are highlighting a multitude of concerns regarding Florida's Medicaid Redetermination process, claiming it results in a lack of coverage for eligible children and families.
During a media call on Tuesday, advocates argued despite the Florida Department of Children and Families' stated plan to manage the unwinding of the public health emergency, the reality has been marked by chaos and confusion.
Official data released in late July by the U.S. Centers for Medicare and Medicaid Services show in the first month after federal continuous coverage provisions for Medicaid ended, 249,427 Floridians were disenrolled, 82% of whom had their cases closed for procedural or "red tape" reasons, such as failure to respond to a notice.
Erica Monet Li, the policy analyst for the Florida Policy Institute, said the state's call center wait time ranks among the worst of the 17 states initiating redeterminations in April.
"48% of the calls made to DCF were abandoned, and the average wait time for an initial contact was 40 minutes before being pushed to another helpline," Monet reported.
The Florida Department of Children and Families has issued guidance on its website. However, advocates say some links to legal aid are not working, language translation from English to Spanish is confusing and needs improvement, and they said the website needs to be modernized with a mobile-friendly option to make it easier for Floridians to navigate.
According to the Centers for Medicare and Medicaid Services, every state must unveil a strategy to streamline re-enrollment and reduce coverage losses.
Joan Alker, executive director of the Georgetown University Center for Children and Families, noted a mechanism called "ex-parte" renewals, intended to simplify income-based verification and auto-renewals, is only being implemented in Florida at approximately 19%.
She expressed concern the state's processing methods might warrant investigation.
"Because Florida has a low ex-parte rate and a relatively high share of children, certainly Florida may be one of the states that are being investigated for this issue, and we expect CMS enforcement to follow," Alker noted.
Advocates said it is difficult to navigate such a complex process and are calling on Florida officials to issue a pause in redeterminations until they fix the problems or able to execute the state's plan properly.
Lynn Hearn, staff attorney for the Florida Health Justice Project, which has a dashboard on its website for tracking the redetermination process, said the group is hearing many stories of people being confused about notices from the state.
"The notice also does not clearly indicate how to appeal or correctly," Hearn asserted. "The appeal instructions are deep in the notice, after a multipage notice, after a full page of QR codes for potentially other irrelevant other programs."
Florida is the only state to not take advantage of the flexibilities offered by the Centers for Medicaid to remedy common issues, and the groups are urging Florida's leaders to focus on fixing current problems to ensure the state's eligible children and families are not cut out of any needed coverage.
