Judge's ruling after revised lawsuit slows fight over Medicaid 'redetermination'

With enrollment in Florida’s Medicaid program continuing to plummet, a federal judge Tuesday dismissed an initial attempt to require the state to at least temporarily reinstate coverage to many beneficiaries and to change the process for dropping people.

Attorneys for Medicaid beneficiaries filed a potential class-action lawsuit in August, alleging that the state was not properly informing people before dropping them from the health care program. As part of that, the attorneys filed motions seeking an injunction and certification of the case as a class action.

But U.S. District Judge Marcia Morales Howard on Tuesday denied the motions as “moot” because the plaintiffs’ attorneys filed a revised version of the lawsuit last week. Howard pointed, in part, to the revised lawsuit including additional plaintiffs, which could affect questions about whether plaintiffs have legal standing to pursue the case.

“Given the substantial time and resources expended on the pending motions, the court considered whether it would be feasible and appropriate to construe the pending motions as pertaining to the amended complaint,” Howard wrote. “However, the amended complaint adds new plaintiffs to this case which significantly impacts the standing analysis, a central issue with regard to both the class motion and the injunction motion.”

The ruling does not end the case, as the revised lawsuit will continue. But it will push back consideration of an injunction and class certification. As an example, Howard gave the plaintiffs a Feb. 20 deadline to file an amended motion for class certification.

The lawsuit is rooted in last spring’s end of a federal public health emergency that was declared in 2020 because of the COVID-19 pandemic.

Medicaid is jointly funded by the federal and state governments, and Washington agreed to pick up more of the tab for the program as part of the emergency.

But in exchange for the extra money, states had to agree that they wouldn’t drop people from the Medicaid rolls during the emergency.

Florida’s program grew from about 3.8 million beneficiaries in January 2020 to nearly 5.78 million in April 2023. At least in part, the increase stemmed from the program being unable to drop people who otherwise might not qualify because of their income levels.

After the end of the public health emergency, the state has used what is known as an eligibility “redetermination” process. That process, which is continuing, has led to hundreds of thousands of people being dropped from the program. As of last month, enrollment was about 4.87 million, according to data posted on the state Agency for Health Care Administration website.

The revised lawsuit filed last week raises similar arguments to the initial version, including contending that the state has violated beneficiaries’ due-process rights and a federal Medicaid law by not providing adequate notice before dropping them from the program.

It seeks an injunction to block the state from continuing the current termination practices and to require the state to reinstate coverage to the named plaintiffs and “all affected class members until timely and legally adequate notice of termination has been provided to them.”

“Medicaid enrollees must be given timely and adequate notice detailing the reasons for a proposed termination and how they can challenge the action, and they must be given an opportunity to make their case before an impartial decision-maker prior to termination of their Medicaid coverage,” the revised lawsuit said.

Attorneys for the Agency for Health Care Administration and the Florida Department of Children & Families have disputed the allegations.

“Plaintiffs’ requested injunction upsets the apple cart with respect to millions of people: those who were found ineligible for full Medicaid whom plaintiffs demand be reinstated, and those for whom eligibility re-determinations would be halted during the pendency of this litigation,” the state’s attorneys wrote in a court document responding to the initial version of the lawsuit. “DCF’s administration of a multibillion-dollar program cannot simply pivot overnight to accommodate chaos of that magnitude.”

Changes in the revised lawsuit included adding as named plaintiffs Jacksonville resident Kimber Taylor and her son, identified by the initials K.H. The lawsuit said their Medicaid coverage was cut off last summer.

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