House, Senate Divided On Medicaid Eligibility Issue

Feb 6, 2020

The Republican-controlled House and Senate are split about whether to permanently eliminate Medicaid retroactive eligibility for seniors and people with disabilities. 

The House Appropriations Committee on Wednesday approved a bill (HB 5201) that would make the change permanent. But the Senate wants to extend the change for one year, including it in a budget “implementing” bill (SPB 2502) for the 2020-2021 fiscal year.

Similar to the budget, an implementing bill only is good for one year. Under the Senate bill, that means the Medicaid retroactive eligibility change would expire July 1, 2021, if lawmakers don’t extend it again next year.

Federal law directs state Medicaid programs to provide 90 days of retroactive coverage to give people time to apply for Medicaid following traumatic incidents or diagnoses of illnesses. That way, people can gather needed information, such as proof of age, citizenship, sources of income and assets.

But state lawmakers in 2018 agreed to change Florida’s policy. Instead of giving patients up to three months, the new policy requires people to apply for the Medicaid program in the same month they seek health care.; a move that saved $104 million.

Lawmakers excluded pregnant women and people under age 21, which means the change impacts seniors and disabled Medicaid beneficiaries.

The change, which required approval from the federal Centers for Medicare & Medicaid Services, took effect last year. The Legislature in 2019 decided to continue the policy through July 1, 2020,  and directed the state Agency for Health Care Administration to provide legislators with information about impacts of the change. That included information on the amount of medical debt that patients have racked up due to the policy; the number of non-pregnant adults who applied for Medicaid while in hospitals or nursing homes between Feb. 1, 2019 and Dec. 6, 2019; and the number of Medicaid applications that were approved and denied.

But AHCA could not complete the study.

Senate Health and Human Services Appropriations Chairman Aaron Bean, R-Fernandina Beach, filed a bill (SB 52) that would make the change permanent, as the House has recommended. But Bean told The News Service of Florida last week that it’s a “harder sell” to make the change permanent without having the benefit of the legislatively mandated analysis.

Meanwhile, before approving its implementing bill Wednesday, the Senate Appropriations Committee added an amendment that again requires the Agency for Health Care Administration to conduct the analysis.

The amendment was sponsored by Senate Minority Leader Audrey Gibson, D-Jacksonville.

“We should extend, give AHCA more time, to give us the information we asked for,” she said.

Social services lobbyist Karen Woodall said she was surprised the House is moving to make the policy permanent without knowing how it affects seniors and people with disabilities.

“There’s no downside to leaving it in the implementing bill and have the time to see what actual impact it has,” Woodall said.