Why is Florida slashing the Medicaid rolls?

Florida has moved with brutal efficiency to cull poor residents from the Medicaid rolls. The state terminated close to a quarter-million people from the program in the past four weeks. Everybody saw this coming; states are winding down coverage from the COVID-era emergency, and a drop in enrollment was expected. But Florida’s outreach to enrollees clearly has failed. The state needs to expand its efforts so those who still qualify don’t arbitrarily lose their coverage.

Congress passed a coronavirus relief package in 2020 that offered states temporary, additional federal funding in exchange for guaranteeing that recipients of Medicaid, a joint federal-state program for low-income people, would retain their health coverage during the pandemic. Tens of millions of Americans were spared nationwide; enrollment in Florida’s Medicaid program ballooned by 1.7 million people. But in April, the Florida Department of Children and Families began to purge the state’s Medicaid rolls as part of the drawdown of COVID-era coverage. Since then, the state has reviewed more than 461,000 people, taking Medicaid benefits away from more than half. About 80% of those terminated — roughly 205,000 — were disqualified because they failed to respond to inquiries needed to renew their eligibility.

Florida cannot turn its backs on 80% of this population just because these residents failed to respond. Common sense says that tens of thousands of them remain eligible or qualify for coverage through other assistance programs. Someone just needs to reach them first.

Health care advocates are calling on Florida to halt its review of Medicaid eligibility, which seems like the prudent thing. Such a high number of people being terminated unilaterally points to obvious gaps in the system. Is the state doing all it can to reach Medicaid recipients? Has it attempted to track down new phone numbers, emails and addresses? Has it worked through medical providers, nonprofits, local governments and others to alert patients about a life-changing move that’s flown largely under the radar?

Activists had warned for months of a “looming tidal wave of health coverage loss” for parents, children and families. Medicaid recipients surely have a responsibility to re-enroll and to complete the registration process. But eligibility is one thing; kicking a quarter-million Floridians off their health coverage because of red tape is another. Expanding Medicaid coverage was an unprecedented move in response to a global health emergency. Winding back to normal should involve the same sense of order, compassion and detail.

This massive shedding of COVID-era coverage will hurt families, while also impacting employers, health care providers and the well-being of communities. Florida is one of only 10 states that have not taken advantage of expanding Medicaid under the Affordable Care Act, and only four states in the nation have stricter Medicaid eligibility. A wholesale disenrollment could cause the state’s uninsured rate to surge and spark an increase in child poverty.

The department needs to ramp up its staffing to connect with clients and process renewals. Doctors, health care providers, nonprofits and faith-based organizations — and especially those that interact with Spanish-speaking communities — need to put the word out and help families complete the paperwork. Many people over a three-year period will have changed their names, addresses and phone numbers; that’s no reason to cast them into limbo. The number of people being dropped is a red flag that the DeSantis administration needs to address.