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More than half of Medicaid recipients terminated may still qualify, state data shows

Florida Agency for Health Care Administration

New data shows that when people reach out to the Department of Children & Families Services, help is hard to find despite the agency's plans and efforts to contact recipients.

As Florida continues its Medicaid redetermination process, state data shows more than half of those removed from Medicaid, were terminated for so-called “procedural,” reasons, like not responding to mail, outdated contact information or computer glitches.

New data shows that when people reach out to the Department of Children & Families Services, help is hard to find despite DCF's plans and efforts to contact recipients.

"We are seeing that the implementations of the plans have not lived up to the standards that were set forth to keep eligible individuals covered," said Erica Moni Lee, a policy analyst at Florida Policy Institute. "For the first time official data backs up the story shared by Floridians having difficulty getting through to the Department of Children & Families on the phone to get help with their redetermination."

In April, states across the country began reevaluating who is eligible for Medicaid after changes from the federal government due to the end of the COVID-19 emergency. Of the 5.5 million Medicaid recipients to be redetermined, DCF has already reviewed 1.4 million cases.

About, 400,000 were terminated from Medicaid, according to the Kaiser Family Foundation. Florida has the second-highest amount of terminated recipients in the country, behind Texas. About 55% were terminated for "procedural reasons," such as not responding to DCF inquiries regarding redetermination.

The Numbers

State data shows Floridians were trying to reach out.

According to the Florida Policy Institute, about 48% of people looking to get help with their redetermination had their calls to the DCF abandoned. The average wait time for callers was 40 minutes before being pushed to another helpline.

Out of the 17 states to begin Medicaid redetermination in April, Lee said Florida ranked last in call center abandonment rates, Lee said, and 16th on wait times.

Advocates report that call center wait times are worse for those who don't speak English. Specifically recounting calls it took four hours to resolve for Spanish speakers," Lee said.

'Children are a large share'

Experts say the vast majority of those who lost Medicaid are children, totaling 120,000 — most of which still qualify for coverage, according to the Georgetown Center for Children and Families.

Joan Alker is the executive director and research professor at the Georgetown center, which is tracking the redetermination process across the country. She said most children should remain eligible for Medicaid or move over to the Child Health Insurance Program, or CHIP, due to wider income eligibility margins.

"We've only seen CHIP go up by about 6,000 So, that in no way is compensating for these losses. And it's also falling way below projections of where CHIP would go during the unwinding process," Alker said. "And it's also falling way below projections of where CHIP would go during the unwinding process."

Projections estimated 100,000 children should have moved to CHIP by now.

Individuals losing their coverage included children with critical care needs and complex conditions.

The federal government launched an investigation into states that are experiencing problems with the automatic renewal process that checks income data to requalify families, often referred to as "ex parte process."

Alker said it was unknown if Florida is one of the states under investigation.

Copyright 2023 WMFE. To see more, visit WMFE.

Joe Mario Pedersen