Health advocacy groups ask Gov. DeSantis to pause Medicaid purge

Orlando Sentinel - 5/23/2023

Health advocates in a virtual press conference on Tuesday called for Gov. Ron DeSantis to pause Medicaid redeterminations after about 250,000 Floridians lost coverage.

The Florida Department of Children and Families removed these residents during an evaluation of eligibility that typically takes place annually, but had been paused nationwide for over three years due to the COVID-19 public health emergency. This pause ended April 1.

A May 9 report from the Florida Department of Children and Families to the Centers for Medicare & Medicaid Services indicates around 80% of those terminated — approximately 205,000 — may have been eligible but lost coverage due to procedural reasons, such as failing to respond to requests for updated information.

Some Floridians in limbo over Medicaid coverage loss

“When governors see such large numbers of terminations of coverage for procedural reasons … they should pause the process and see what is going wrong,” Joan Alker, executive director and research professor at Georgetown University Center for Children and Families, said during the call.

According to Florida’s plan, residents are supposed to receive instructions on how to renew their coverage 45 days before their renewal date. Notices and instructions should come via letters, emails, texts and calls, assuming residents have updated their contact information via their MyACCESS account, which should also have information on when a family’s redetermination is scheduled.

In this first round, 461,000 people underwent review, and coverage was taken away from more than half. The state has estimated that nearly 1 million of the 5.7 million residents currently receiving Medicaid will be taken off the rolls within the next year.

Just as advocates have warned for the past year, some families say they did not receive a redetermination or termination notice. They discovered they lost their insurance during doctors’ appointments, while at addiction facilities, or when trying to fill prescriptions, said Miriam Harmatz, advocacy director and founder of the Florida Health Justice Project, on Tuesday.

A letter released alongside the press conference, signed by 52 organizations, states that a pause would give the state time to analyze and identify issues with the process, “fill critical vacancies at DCF,” and give DCF staff more training on the process.

Health advocacy groups such as the Florida Health Justice Project are working with the state to identify what went wrong and fix these issues.

“This is a huge undertaking, a Herculean task, and we want to, you know, maintain open, robust communication with the state,” Harmatz said.

Alker also called for Florida to go beyond monthly reports and release data on disenrollments in real time, as several other states are doing.

“Florida’s governor should commit to data transparency and engage all available resources to make sure Florida’s already-high child-uninsured rate doesn’t go even higher,” Alker said.

She pointed out that the state is required to report the number of kids ineligible for Medicaid and referred to Florida Healthy Kids, another insurance option offered by the state to low-income Florida residents. However, the state’s May 9 report to Centers for Medicare & Medicaid Services does not include this information.

Appeals are another aspect of the process that needs improvement, Harmatz said.

Floridians can appeal the state’s decision to remove their coverage within 90 days of the notice, and stay covered while their appeal is pending. Florida’s Medicaid termination notices fail to give information about how and where to appeal online, instead directing people to call centers or to visit DCF offices in-person.

Harmatz recommends sending an online request on DCF’s website or by sending an email to appeal.hearings@myflfamilies.com.

Florida also differs from most states because it is one of 10 that did not expand Medicaid eligibility to low-income, childless adults. About 415,000 Floridians were stuck in this gap before the pandemic, a number expected to grow.

Ccatherman@orlandosentinel.com; @CECatherman Twitter