More than half a million Floridians have lost their health insurance since Medicaid redeterminations began in the state, and officials still have to determine whether over two million more will remain covered.
Health officials updated lawmakers on the redetermination process during a Senate Appropriations Committee on Health and Human Services meeting on Wednesday. Florida began disenrollments in April, and enrollment declined by 524,076 through August, according to KFF. More than 1.5 million enrollees renewed their coverage and 730,737 enrollees were disenrolled, including 358,851 who were determined ineligible and 371,886 who were disenrolled for procedural reasons, according to KFF.
The Florida Department of Children and Families (DCF) does the majority of redeterminations for enrollees in the state’s Medicaid program, including parents, caretakers, children, and disabled residents. DCF Deputy Secretary Casey Penn said about 4.6 million individuals will have their cases redetermined over a 12-month period ending in March 2024. The state’s most vulnerable populations will be redetermined last, he said.
“We have about 2.4 million individuals left to do between now and the end of March (2024),” Penn said.
DCF has conducted extensive outreach to try to raise awareness about the redetermination process so residents can either renew their coverage or, if they are no longer eligible for Medicaid, explore other options. Staff have reached out through email, texting, and automated calls.
Medicaid recipients received five to 13 contact attempts from DCF, Penn said. It sent over four million text messages, 3.1 million emails, and made 297,000 calls to non-responsive recipients through August.
Penn discussed procedural disenrollments, which occur when recipients do not provide the department with information necessary to complete a redetermination. According to KFF, 32 percent of the residents who have been disenrolled were for procedural reasons.
“Florida has one of the lowest national rates of procedural terminations, coming in ninth. The eight states below us have been asked to pause procedural terminations by (the Centers for Medicare and Medicaid Services). So in my mind, we’re doing better than anyone else when it comes to procedural terminations.”
— Penn
Sen. Tracie Davis (D-Jacksonville) asked how Medicaid expansion would affect the redetermination process. Florida is one of only 10 states that has not expanded its Medicaid program under the Affordable Care Act to adults ages 19-64 with income under 138% of the federal poverty level.
“I’m going to address the elephant in the room that we haven’t talked about,” Davis said. “Where does Medicaid expansion fall? What type of money are we leaving on the table with Medicaid expansion? How would Medicaid expansion help you?”
Penn said Medicaid expansion would not entirely solve all the problems with the redetermination process.
“When we talk about Medicaid expansion, a lot of the concerns nationwide with procedural enrollments aren’t going to be solved by Medicaid expansion because they still have to be determined every 12 months,” Penn said. “The process stays the same whether you expand or not.”
Committee Chair Sen. Gayle Harrell (R-Stuart) expressed concern for the state’s youth Medicaid population.
“It’s of great concern to us, especially considering the number of children that receive their healthcare through Medicaid. We want to make sure our kids are covered either through Medicaid or KidCare.”
— Harrell
Harrell noted that lawmakers were able to expand KidCare through House Bill 121 during the 2023 legislative session. The bill increases the income eligibility threshold for coverage through the program, and allows children living in families earning 300% of the federal poverty level (FPL) to qualify for KidCare coverage.
Penn said DCF has referred kids who were deemed ineligible for Medicaid to Florida Healthy Kids. Adults were referred to the federal marketplace. Florida Healthy Kids Chief Marketing Officer Ashley Carr said 67,091 new children were enrolled in the Florida KidCare program, including those who are Medicaid-eligible, since April.
“That’s out of 140,750 children referred since April,” Carr said. “There have been 167,000 children sent over as procedural terminations since April. Between 7,500 to 8,500 were disenrolled each month (since April) for a variety of reasons.”
DCF has been working tirelessly to improve its technology during redeterminations, Penn said. It will launch the new My ACCESS portal this fall, which will give individuals an enhanced and user-friendly platform to manage their benefits.
“It’s going to have enhanced features with mobile-friendly versions, ease of use, and (will make) the process more convenient and informative for our individuals,” Penn said. “We developed a pretty robust communication strategy working with community partners, different managed-care plans, and direct communication with Medicaid recipients.”