'Trying to survive': Families suddenly dropped from Medicaid seek reinstatement

Vanessa Brito, a public policy analyst and community activist in Miami, has been busy on Facebook alerting Medicaid recipients around Florida to make sure they haven’t been booted off the government medical insurance program for low-income families and individuals.

“I'm getting people that are either going to the doctor or going to the pharmacy to pick up their refill for the month, and they're being told, 'Well, your Medicaid is no longer active,' " Brito said.

Brito’s worries are well-founded.

The nation's Medicaid rolls swelled during the coronavirus pandemic as states, including Florida, were prohibited from ending people's coverage. But that came to a halt in April, and states must reevaluate recipients' eligibility — just as they had been regularly required to do before the pandemic.

As a result, large numbers of lower-income people are losing health care coverage due to administrative reasons, according to the Biden administration, which this week urged states to slow down their purge of Medicaid rolls.

In some states, about half of those whose Medicaid renewal cases were decided in April or May have lost their coverage, according to data submitted to the Centers for Medicare & Medicaid Services and obtained by the Associated Press. The primary cause is what CMS describes as “procedural reasons,” such as the failure to return forms.

Brito is hearing from those Medicaid recipients firsthand through her Facebook account.

One of her Facebook followers, Melissa, who asked WLRN not to use her last name because she worries speaking out might impact her employment, said she got no notice from state officials. She lives in Titusville, and her children recently lost their Medicaid coverage.

"We never got anything telling us to recertify," she said. "We never got anything saying we were booted out of the system.”

Thousands no longer qualify for Medicaid

The state agency that administers Medicaid identified some 900,000 people in Florida that no longer qualify for Medicaid and will lose it. Nearly 6 million people are enrolled in the Medicaid program.

Florida is one of 10 states that have rejected efforts to expand Medicaid eligibility. The Republican-majority Legislature has long raised concerns about the potential future costs.

So far, hundreds of thousands of people have already been removed from this health coverage since April.

They weren't removed sooner because throughout the COVID-19 pandemic, the federal government gave money to states to keep people enrolled even if they no longer qualified. Those protections ended on March 31.

Most Medicaid recipients in Florida who lost coverage didn’t know they needed to turn in paperwork to the Department of Children and Families, the state agency that determines Medicaid eligibility, say activists.

"They couldn’t verify a home address; they couldn’t verify the household size; or they couldn’t verify a phone number," said Shirley Dominguez, who works for Epilepsy Alliance Florida as a navigation program community engagement specialist. She's also a senior lead navigator.

Florida Department of Children and Families

"People that have multiple illnesses have been dropped; people that are disabled have been dropped just because of these procedural errors," Dominguez said.

Some health policy experts in Florida — and across the U.S. — say the state should stop the procedure of unenrolling people until the errors and glitches can be fixed.

"If we're seeing 80% of terminations were procedural, there's something wrong," said Alison Yager, the executive director of the Florida Health Justice Project. She spoke as part of a panel at the 2023 Florida Voices for Health Summit in Rockledge. "Let's pause and figure out what's not working and proceed when we're ready and sure that the damage is going to be significantly less."

Biden administration officials are urging state officials to review their practices on removing Medicaid recipients.

"I am deeply concerned with the number of people unnecessarily losing coverage, especially those who appear to have lost coverage for avoidable reasons that state Medicaid offices have the power to prevent or mitigate," Health and Human Services Secretary Secretary Xavier Becerra wrote in a letter Monday to governors. Becerra wrote that a change of address shouldn't make a person uninsured if they qualify for Medicaid.

Alison Yager of the Florida Health Justice Project did point out, though, that DCF staff is helping those mistakenly removed get covered again.

Said Yager: "They are understaffed and under-resourced, and they are really taking on a Herculean effort."

DCF reaches out

Since April, the majority of those contacted by DCF have responded to the redetermination request — meaning they've provided the paperwork they were asked to submit, DCF officials told WLRN in an email.

"Even if an individual fails to submit a timely response, they have 90 days to submit their information and their coverage will be retroactive if they are still eligible," wrote Tori Cuddy, DCF’s Northwest Region communications director. She added that DCF is processing applications that came in late.

"Any individual who has a pending redetermination application with the department will maintain their coverage until an eligibility determination is made," Cuddy wrote. "The department is utilizing an aggressive text and email effort in addition to traditional mail, and if all of those efforts are unsuccessful, we are calling customers to inform them that their redetermination is past due and to encourage them to respond to the department."

Since the federal rules changed and states started taking people off Medicaid, nonprofits and advocates have also been stepping up to help people figure out what to do. Epilepsy Alliance Florida aired ads in Spanish and English on the radio.

Medicaid recipients who suddenly lose coverage face enormous pressure to be without health insurance — even temporarily.

Consider Melissa, the Titusville mother who recently reached out on the Miami activist’s Facebook page.

Melissa's daughter needs expensive medication for diabetes because she's resistant to insulin. Her son has a condition, supraventricular tachycardia, that causes an irregularly fast or erratic heartbeat. Sometimes he needs hospitalization. Melissa has a flexible contract job in the nursing industry so she can pay for her children's medication and be available for them when they need her.

She does not get health care benefits from her job and neither does her husband, so they're uninsured, too. Melissa told WLRN they barely make enough to pay for the vitals, like food and medication.

"All we're trying to do is survive," she said. "Does it seem fair for the working people who are barely getting by? It doesn't. Then you take away the one thing that they need — health care. How are we going to be healthy enough to continue working?"

Copyright 2023 WLRN 91.3 FM. To see more, visit WLRN 91.3 FM.