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What to know ahead of a hearing to examine Florida's Medicaid redetermination process

Small boy complaining about pain in his throat while talking to African American doctor at pediatrician's office.
Drazen Zigic

A hearing before a U.S. judge is slated for Oct. 30 to decide on an injunction. Here, WUSF's Sky Lebron spoke with Health News Florida reporter Stephanie Colombini on the process and pushback the state is getting legally.

Hundreds of thousands of people across the nation are being unenrolled from their Medicaid coverage following the suspension of the COVID-19 public health emergency earlier this year.

Florida has been one of the most aggressive in this removal process. WUSF's Sky Lebron spoke with Health News Florida reporter Stephanie Colombini on the unenrollment process, and pushback the state is getting legally, and from advocates.

So just for some context, why are all of these people in the state being disenrolled from Medicaid coverage this year?

It all goes back to COVID-19. Early on in the pandemic, the federal government told states, 'we're going to give you extra money to help with your Medicaid programs. And in exchange, we want you to keep all of your beneficiaries continuously enrolled,' because they understood how unstable a time it was with the pandemic and didn't want people losing coverage. So regardless of somebody’s Medicaid eligibility, if that had changed their income status, they were going to keep their coverage. This year, that changed. The public health emergency ended and states were tasked with re-determining eligibility for millions of Americans. They were given a year to do it. But Florida definitely got started quick — over half a million people have already been disenrolled. And about 250,000 or so are kids.

By The Numbers

With the end of a federal public health emergency from COVID, enrollment in Florida’s Medicaid program has decreased during the past five months. Here are enrollment numbers over the past year:

  • October 2022: 5,537,393
  • November 2022: 5,577,363
  • December 2022: 5,638,561
  • January 2023: 5,696,638
  • February 2023: 5,733,610
  • March 2023: 5,751,117
  • April 2023: 5,778,536
  • May 2023: 5,543,890
  • June 2023: 5,427,530
  • July 2023: 5,360,069
  • August 2023: 5,254,460
  • September 2023: 5,161,884

Source: Florida Agency for Health Care Administration

SL: And has the removal process been smooth?  What has this redetermination process been like so far?

SC: Depends who you ask. The state is defending its process. They say they have a 87% response rate in terms of families getting renewal notices and then responding. I'm hearing differently from advocates. There’s been multiple calls for Florida to pause its Medicaid renewal process because they say families are having a hard time, or at least some families are getting confusing notices in the mail. There's long waits at call centers, particularly for people who speak different languages, that families are losing coverage who shouldn't be, that have kids with complex health conditions. Some are finding out in the doctor's office they've lost Medicaid. So that's a really scary thing for families. And the biggest concern people have nationally are what's known as procedural terminations. This is when you don't lose Medicaid because you don't qualify anymore. It's because of an administrative error. Maybe you miss something in the mail or you didn't fill out a form correctly. Florida's rate for those is better than the national average. But we have a huge population. And so some families have sued to change this.

SL: So right now, the state is facing that class-action lawsuit that you just brought up also a civil rights complaint on their process of dropping coverage for people. How's that been going?

SC: The federal civil rights complaint was filed by a group of advocacy organizations who say that Florida's Medicaid redetermination process isn't fair for residents who are Latino, immigrant or Black. Some issues they bring up are that the Medicaid website isn't smartphone friendly, and also that people who need help in another language like Spanish are waiting a lot longer at call centers for help compared to English speakers. Then there is a potential class-action lawsuit. And that was filed on behalf of two families in August, and plaintiffs are arguing that the state isn't adequately informing families about why they're losing their Medicaid, or giving them enough information about how to appeal. And so they want to make that a class-action lawsuit so that anybody who feels they were treated that way could benefit. And they're also asking a judge to issue an injunction that would make the state pause the process until it can better inform families and reinstate coverage for people who lost it. The state is pushing back on this, not only defending its process, but asking a judge not to make this a class-action lawsuit, and not to issue that injunction, saying that that would cause chaos for the program. So there's a hearing on the issue on Oct. 30. And we're curious to see what happens.

SL: Last week, there was actually a state Senate Health Committee hearing on this redetermination process. What was said in that meeting?

SC: One thing that we learned is that the state recently launched a dedicated phone line for Medicaid redeterminations that officials say has cut down on wait times a lot. The state was also defending how it's helping families move from Medicaid to other forms of health insurance, like Florida KidCare. That's a low-cost program for kids who come from families with low incomes. And the state said that there’s been more than 67,000 new enrollments into KidCare since this process began in April. But advocates say that still leaves a big gap where there's thousands of kids who've been disenrolled from Medicaid that we don't know where they're going. Are they on their parents employer insurance now, or are they becoming uninsured? And I think that's the real concern advocates have right now is that there's kids who maybe should still be on Medicaid that are going without coverage.

Copyright 2023 WUSF 89.7

Stephanie Colombini joined WUSF Public Media in December 2016 as Producer of Florida Matters, WUSF’s public affairs show. She’s also a reporter for WUSF’s Health News Florida project.