There are about 250,000 people who have lost Medicaid coverage since Florida began its redetermination process this month, however, many of those people could still be eligible.
In April, state governments were allowed to begin checking people's eligibility for Medicaid due to the expiration of the continuous enrollment provision, which ended on May 1. The federal government instilled the provision at the height of the COVID-19 pandemic in 2020 as people were losing jobs and health insurance coverage.
In Florida, the number of individuals and families seeking Medicaid assistance rose from 3.8 million to 5.5 million between March 2020 and last November. About two-thirds are children, according to the Georgetown Center for Children and Families.
State data show that 10% of those who lost coverage were terminated because they were ineligible or hadn’t used Medicaid over the past 12 months. However, 82% of people lost coverage for procedural reasons, also known as "red tape" reasons, such as not having responded to mail, having outdated contact info or computer glitches.
And a poll this week from KFF found that 65% of Medicaid enrollees across the country didn't know states can now remove people from the program if they are not eligible or don't complete the renewal process.
Joan Alker, executive director and research professor at Georgetown Center for Children, said the majority of terminated cases include families with children. Many of them appear to be learning about their lost coverage while trying to access care from a provider.
"Parents and caregivers could lose coverage for their children simply because of a language barrier, a recent move, or something as innocuous as a new phone number," Alker said. "Unfortunately, parents may fall into the coverage gap. But most children will likely remain eligible for Medicaid."
Who is most affected?
The Florida Health Justice Project found those who have already lost coverage include families with children who have complex medical issues and are now threatened to pay for procedures out of pocket.
Erica Monet Li, a public health expert at the Florida Policy Institute, has found that many who have lost coverage were unaware they were terminated from Medicaid.
"We owe it to these Floridians to figure out what's going on," she said. "We have to keep in mind as was also stated earlier that the pandemic uprooted so many lives, and those who have moved might not have received the proper notices."
Additionally, the interruption of health care services in the Medicaid unwinding is expected to impact minority communities much more heavily, said Lavon Brown, a research director at the Northeast Florida Healthy Start Coalition. This includes children suffering from high cholesterol due to obesity and those in need of diabetic medication.
"It will further delay health services to this underserved population," she said. "It will worsen the health status of many children and their families. The net result will be a higher cost to health care to the country in the long run and a worse health outcome to these populations."
A call to pause action
As a result, 52 Florida health policy centers and health care organizations, including the Florida Policy Institute, signed a letter to Gov. Ron DeSantis urging the Department of Children & Families to pause Florida’s current Medicaid redetermination process.
The pause would allow DCF and other experts a chance to review why such a large rate of people lost coverage under red tape reasons.
The Florida Policy Institute said in its letter to DeSantis that its received reports of "Floridians being disenrolled from Medicaid without having received notice from DCF, as was outlined by DCF in the Florida Medicaid Redetermination Plan."
Florida reports that 145,000 cases were rolled over into the next month. Alker said that will further stress out the process , which will examine over 5 million cases in a year’s time.
Many eligible for subsidized private coverage
Overall, more than 900,000 Floridians could soon lose Medicaid. Tracy Melin, with the Big Bend Area Health Education Center, says up to 60 percent are eligible for subsidized private coverage under the Affordable Care Act.
“If they’re going to be terminated, they go to Healthcare.gov to fill out an application. And that can be confusing," she says. "And so they may need a navigator to help them, and if they reach out to us at Big Bend AHEC, we can meet with them one-on-one, via Zoom or in person, and set up an application together, answer questions, and then compare plans and help them make an informed decision for their health insurance.”
Melin says another option is Florida KidCare, for which the Legislature just expanded eligibility. Those income limits are now 300 percent of the federal poverty level, as of January 2024.
She also says beneficiaries should update their contact information on ACCESS Florida, the system used by the state to communicate with Medicaid recipients.
“And then watch your mail," she says. "They will be reaching out to you initially through snail mail, but also through email, phone, text message − look for those things. And if you get a request for information, answer."
A frustrating experience
Liz Adams of Plant City has two kids and they were among those in Florida who lost coverage in April. She found out while trying to figure out the time of her son's biopsy appointment. Her son survived leukemia and has a variety of ongoing health problems.
"I called the surgery center [asking] what time is this appointment? 'Oh, we canceled that. He doesn't have insurance," she says. "So I jump on the portal and sure enough, they don't have insurance."
She was incredibly frustrated that she then had to try and reenroll her children in health insurance, while figuring out how to get her son's care back on track.
"I waited a year to get in with a rheumatologist, and we finally got the biopsy and we finally got blood work ordered, and I can't go do any of it because they canceled my insurance," she says.
With the help of the Family Healthcare Foundation, she was able to sign up her kids for new coverage, and she eventually got her son's biopsy rescheduled for the end of June.
Some state reports are reassuring
Some other states have also dropped many people from Medicaid. But Alker says that unwinding is not going badly in every state.
"We're really seeing divergence here," says Akler, with the Georgetown Center. "We've seen very, very concerning numbers from Florida, from Arkansas, from Indiana, but we've seen much more reassuring numbers from Arizona and Pennsylvania."
In Pennsylvania, for instance, only 10% of people whose Medicaid eligibility was reviewed in April lost coverage, and in Arizona, that figure was 17%, according to a state report.
The federal government can require states to pause disenrolling people from Medicaid when there are problems, Alker says, but it remains to be seen if federal health officials will use that enforcement power.
"I am very worried about Florida," Alker says. "We've heard the call center's overwhelmed, the notices are very confusing in Florida – they're very hard to understand."
Information from NPR's Selena Simmons-Duffin and WFSU’s Margie Menzel was used in this report.
