When the state strands Medicaid kids, what then?

Since April 2023, approximately 420,000 Florida youths have been disenrolled from Medicaid, according to the McCourt School of Public Policy at Georgetown University. The local impact on Palm Beach County alone is significant: According to the Florida Policy Institute, between April and December 2023, nearly 32,000 children here lost coverage.

Why the sudden impact? Until April 1, 2023, due to the Public Health Emergency Act in place in response to COVID-19, the federal government gave money to states to continue providing Medicaid to those who qualified at the start of the pandemic, regardless of their current eligibility. As a result of the expiration of the Public Emergency Act, many individuals have been disenrolled from Medicaid. While many are considered no longer eligible, a third of children have lost coverage through “administrative disenrollment” – meaning their parents did not successfully complete the renewal process before the government’s deadline.

Florida is the only state that has not opted to use policy flexibilities offered by the U.S. Department of Health and Human Services that minimized terminations of Medicaid coverage for procedural reasons, or “red tape.” Because Florida is one of 10 states that have not opted to expand the Medicaid program through the Affordable Care Act – which expands the program to cover all people (including adults) with household incomes below a certain level – the majority of Florida Medicaid recipients are 21 years old or younger (66.7% as of January 2024). Unfortunately, this means the vast majority of those losing insurance since April 2023 are children, parents, young adults and new mothers.

There was hope that children who were no longer deemed eligible for Medicaid would transition to other forms of coverage, such as the Child Health Insurance Program (CHIP), known in Florida as Florida Kid Care, or enroll in plans offered on the federal marketplace. This unfortunately has not happened.

And while Medicaid disenrollment first began last April, many families are still not aware of the change, or are just now learning that they are no longer covered.

For those who have not been to the doctor in the past year, they may not even realize that they’ve been unenrolled. If unenrolled, they are facing the possibility that their insurance is no longer active, which could cause delays in care, forgoing acute care, preventative care, and/or care for chronic conditions. And because of how challenging it is to quickly get medical coverage, parents are faced with the difficult decision – either pay in full for services, which is costly and many do not have this ability, or avoid getting care, which leaves children at increased risk for poor health outcomes.

A third option is using emergency rooms for nonemergency care – because hospitals are required by law to provide care regardless of patients’ ability to pay. This is not ideal because it is not a substitute for patient-centered primary care and it exhausts vital hospital resources.

So, if you’re in this position, or know someone who is, here’s what you can do:

Don’t wait for the child to get sick. Check today their Medicaid status on the Department of Children and Families (DCF) website: https://myaccess.myflfamilies.com. Medicaid recipients should have been informed, via email or mail, if they were unenrolled. If you did not receive that email, or are not sure if you did, contact the DCF at 850-300-4323.

If you need help renewing or applying for Medicaid, go to https://myaccess.myflfamilies.com/ or call DCF’s service center at 850-300-4323 from 7 a.m.-6 p.m. on weekdays. Another option: Contact the doctor’s office where you used Medicaid benefits previously and ask them to verify if your coverage is active. Or, use a certified navigator, a person trained to help consumers with health care options. To find a navigator, visit www.my floridacfo.com.

Shannon Fox-Levine is a pediatrician and owner of Palm Beach Pediatrics, with offices in Boynton Beach, West Palm Beach and Loxahatchee Groves. Learn more at www.pbpediatrics.com.