About 1 million Floridians will get kicked off Medicaid. How would that affect the state?
The end of the federal public health emergency’s continuous enrollment provision means changes are ahead. State officials stand divided about the implications for Florida and its people.
About 1 million Floridians will soon lose Medicaid coverage in April due to the end of the public health emergency’s continuous enrollment provision.
In December, President Joe Biden signed into law the 2023 Consolidated Appropriations Act, which brought an end to the emergency provision that required states to provide continuous Medicaid without removing individuals.
Continuous Medicaid enrollment began as people lost their jobs due to COVID-19 regulations at the start of the pandemic, with many of those jobs being in the restaurant and hospitality industries, said Meredith Robertson, a University of Central Florida health insurance associate professor.
“Back then, their income was much lower and so they would qualify for Medicaid, but likely today they have a new job, and so now their income is higher, so they're going to lose that eligibility,” she said.
How it affects Florida
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.
The Urban Institute, a Washington, D.C., think tank, estimates about 18 million people throughout the nation will lose Medicaid coverage in April — about 3.2 million of those will be children. However, about 9.5 million people will probably get employer-sponsored insurance, Robertson said.
Estimates on how many Floridians will be no longer eligible vary between 900,000 and 1.75 million residents.
"One of the biggest differences to keep in mind is that Florida is one of the few states that has not expanded Medicaid," Robertson said. "And so in some states, the income level of eligibility is much higher than it would be in Florida, and it includes coverage of people like those 19- to 20-year-olds. Whereas in the state of Florida, those individuals would no longer qualify for Medicaid."
The end of the Medicaid provision comes as good news to some lawmakers citing the cost burden on the state. Medicaid costs Florida around $230 per person a month — an expense state Sen. Randy Fine said extended to those who might not need Medicaid anymore.
“If you qualified for Medicaid at the beginning of the pandemic, and then got a job, we have been paying $223 a month for you and your family; you had for people $800 a month, and no one has been benefiting from that except the Medicaid managed care,” Fine said.
By cutting the provision, Florida would save $1 billion, Fine said, money he’d like to see spent in other sectors.
“We could spend it on education or roads or the environment, or we could cut taxes by a billion dollars or we could put it in the piggy bank for a rainy day, but this is a billion dollars plus of expenditures, we will not have,” he said.
When it comes to the question of expanding Medicaid, Fine said there was no room for that notion in Florida.
"The reason for that is Medicaid largely protects those who have children and/or are unable to work," he said. "If you are an able-bodied adult without children, the way to get insurance is to get a job."
Not all Central Florida lawmakers feel the same. State Sen. Geraldine Thompson is concerned about those whose income is just barely over the threshold for Medicaid eligibility; a population she refers to as the working poor.
“They don't make enough for their own private insurance, which is kind of being caught in the middle, and when the public emergency goes away, they're left stuck,” she said. “And a lot of these will be women and children and particularly postpartum women and young adults. They’ll be the hardest hit.”
Thompson's big concern is whether or not individuals of this group can be reached in time before they're in need of insurance. If they're hurt or sick and arrive in the hospital without insurance, they may be in danger of falling into a very expensive problem, Thompson said.
"Without health coverage, people use the emergency rooms as the first point of contact for health care. And emergency rooms are the most expensive form of health care," she said.
The Department of Children and Families is tasked with informing at least 900,000 ineligible people of their status — a task the department may not have the manpower for, Thompson said.
“Well, we have technology that can handle the number of calls and it and, you know, just what we experienced with reemployment assistance has made me very concerned that the department may not be able to handle the volume because it's all coming in at one time,” she said. "That's the mountain that DCF is trying to climb."
There are about 40 nonprofit health care advocacy organizations that are working with the state to lighten DCF’s load, Thompson said. However, she fears it's not enough, and the state should lead an education initiative to inform people about the coming changes and options available.
"If we don't complete this we're going to have a lot of people who are just kind of dangling in the wind," she said.
If DCF determines someone as ineligible, they’ll be offered a plan from the Affordable Care Act Marketplace, which will be given a special extension for those being removed from Medicaid. Children will automatically transfer to the Florida Healthy Kids program or other subsidized programs depending on their age.
What to do if you're on Medicaid
If someone is unsure of eligibility, officials recommend calling DCF or the state Department of Health to discuss status and options.
Also, it's important to make sure a resident's address is up to date with DCF so the agency can send updates on a resident's status.
Department of Children & Families -1-850-300-4323
Florida Department of Health: 1-877-888-7468
You can also look for health insurance plans available in the ACA marketplace at Healthcare.gov.
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