Florida’s safety net programs are key to caring for some of the state’s most vulnerable communities. However, as some state flexibilities implemented during the pandemic begin to expire, advocates such as the Florida Policy Institute (FPI) are concerned about leaving some families without adequate care or resources.
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Florida’s Medicaid population has dramatically increased since the beginning of the pandemic—about 1 million individuals have enrolled since March 2020. The federal COVID-19 public health emergency (PHE) declaration currently prevents any Medicaid disenrollments. However, once the PHE expires, states are faced with the task of not only redetermining the eligibility of their beneficiaries, but also forming a plan to refer those who are no longer eligible to other coverage options.
“We’ve been talking with some of our state officials, but it’s still vague on what the plan will be,” said Anne Swerlick, FPI senior policy analyst. “They are trying to figure out if there’s going to be anything more that’s coming down the pipe from the federal level, like the Build Back Better [Act].”
Swerlick also noted the consequences of the Medicaid redeterminations may be more severe for Florida because it’s a non-expansion state. There has been little movement to push for expansion since 2015, when a bill to do so passed the Senate but failed in the House.
Past measures have restricted Medicaid access to cut spending costs, Swerlick said. This included the removal of retroactive Medicaid eligibility, which provided coverage for any medical services a beneficiary incurred up to three months before their enrollment.
“[The legislature] estimated [retroactive eligibility] was costing the state about $40 million a year,” Swerlick said. “[The loss of benefits is] a huge loss, especially for people with disabilities and severe and expensive illnesses.”
Other programs, such as the Supplemental Nutrition Assistance Program (SNAP), which provides nutritional support for low-income seniors and people with disabilities, also saw flexibilities revoked. In July 2021, SNAP ended emergency allotments, which allowed beneficiaries to receive the maximum amount of aid allowed per family size. The removal affected about 1.7 million Floridians, according to FPI senior analyst Cindy Huddleston.
During the pandemic, the Florida Temporary Assistance for Needy Families (TANF), which provides cash assistance, removed work requirements for beneficiaries, allowing them to continue receiving aid even as businesses closed to limit community spread. However, those work requirements were reinstated several months ago.
“A lot of people who have been hurt by that, particularly in the TANF program, are mothers of young children who could not get vaccinated because of their age,” Huddleston said. “It left mothers in a dilemma of what they were going to do. Were they going to go back to the workforce? Were they going to stay with their child? It put them in a really bad position.”
In the absence of those flexibilities, nonprofit organizations have worked to fill the gap, although Huddleston said they too are overwhelmed during the pandemic.
“There’s just a bunch of puzzle pieces that we haven’t yet put together to figure out what the repercussions have been of pulling back on these flexibilities,” she said.
Despite the gaps in care that face the safety net community, one benefit has been an increased sense of collaboration among organizations and advocacy by the general public.
“The pandemic has increased people’s awareness and sensitivity about people who need help through the safety net,” Swerlick said. “It’s touching a lot more friends, family, and neighbors. That is really invaluable in trying to do advocacy to improve these programs.”