A lawsuit filed against Florida health officials marks the first legal challenge that seeks to halt a state’s termination of residents’ Medicaid benefits since the redetermination process began.
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The lawsuit was filed in Jacksonville on Aug. 22nd on behalf of a 25-year-old woman, her two-year-old daughter who has cystic fibrosis, and a one-year old girl. It lists the state’s Agency for Health Care Administration and the Department of Children and Families (DCF) as defendants.
The plaintiffs claim the state illegally cut their Medicaid coverage by not providing adequate information and denying them an opportunity for a pre-termination hearing. They state that the notices agencies are distributing to inform enrollees they are no longer eligible for Medicaid are confusing and don’t provide sufficient explanation as to why they are losing coverage.
“Among other things, defendants routinely fail to include in the Medicaid notices the legal or factual basis for the agency’s decision. Instead, the notices use a set of standardized reason codes, many of which provide little or no explanation of the actual reason for the agency’s decision.
These standardized notices have been used for years. Since before the COVID pandemic, defendants have been well aware that notices sent to beneficiaries generate confusion and that the current notices that describe applicants as ineligible are considered to be not sufficiently explicit in terms of an explanation.”
DCF began reviewing approximately 5.5 million enrollees for eligibility on April 18th as the public health emergency’s continuous Medicaid coverage provision ended. A DCF official told CNN the lawsuit was “baseless” and said letters sent to recipients were “legally sufficient.”
The lawsuit states that improper terminations will continue for the foreseeable future without the court’s intervention.
“Plaintiffs seek preliminary and permanent declaratory and injunctive relief to require defendants to stop terminating Florida Medicaid enrollees until adequate notice and an opportunity for a pre-termination fair hearing has been provided.”
More than 5.5 million Medicaid enrollees have been disenrolled in 47 states and Washington, DC, as of Aug. 29th, according to KFF. Disenrollments in Florida began in May, and enrollment declined by 418,467 enrollees from April to July.
As of June, 897,625 enrollees renewed their coverage and 408,371 enrollees were disenrolled in Florida. That includes 182,857 Floridians who were determined ineligible and 225,514 residents who were disenrolled for procedural reasons.
Florida’s disenrollment rate is currently at 31 percent, according to KFF. Texas has the highest disenrollment rate at 72 percent, while Wyoming has the lowest disenrollment rate at eight percent.