Millions could soon lose Medicaid. Here's who and what happens next
Millions of Floridians stand to lose Medicaid after a provision that allowed for continuous enrollment in the program comes to an end Saturday.
The provision was first launched in 2020 to help Americans who were losing their jobs retain health insurance during the beginning of the Public Health Emergency caused by the COVID-19 pandemic.
The continuous enrollment Medicaid provision ends April 1st. Now, the Florida Department of Children and Families is tasked with reaching out to Floridians and informing them of their ineligible status. The first round of yellow-striped envelopes was sent out in March and will continue to be sent over the next 14 months.
Who is losing Medicaid?
The first to lose Medicaid benefits could come at the end of April, which could include adults and kids.
“In Florida, it actually covers about two-thirds of children," said Joan Alker, director of the Center for Children and Families. "I know when we hear Medicare we think of seniors but I'm not sure everybody thinks of children when they hear Medicaid.”
Currently, there are 5.5 million people on Florida Medicaid. That's up from 3.8 million prior to the pandemic. DCF will begin its redetermination process with those who have not accessed their Medicaid benefits in the last year, which is about 900,000 cases.
In total, there are about 1.75 million cases that are at the highest risk of losing Medicaid, according to state data. However, all 5.5 million people will be reviewed for redetermination, Alker said, but it will be children who are the hardest hit.
Potentially three million children will be affected by the redetermination process, Alker said. However, some of those kids will actually be eligible -- while their parents lose coverage, their kids may still qualify.
That could happen due to different income requirements for adults.
Why there could be mistakes
Parents could run into issues if they find the letters confusing, or if they don't speak English and require a translation, Alker said.
"A lot of their parents are probably no longer going to be eligible because Florida hasn't expanded Medicaid," she said. "What happens a lot of times, particularly if the notice isn't clear, is the parents are gonna think the child is also not eligible anymore. We're very worried about that, that we could lose children even though they'll remain eligible.”
To avoid confusion, the department will be sending a different envelope to each member of the family informing them of their status, said Anne Packham, director of the Primary Care Access Network.
"Some families will want to be looking out for more than one envelope," she said.
A path to coverage
Even if adults or children are kicked off Medicaid, there’s still a path to coverage.
The state's estimating conference projected 100,000 kids will need to move from Medicaid to Healthy Kids in Florida, part of the Children's Health Insurance Program.
Children could be eligible for Florida Kid Care, which would cost families about $15 to $20 a month, Packham said.
"For people who are making a little bit more money for parents making more money, DCF will automatically forward a child's Medicaid application to Kid Care for review," she said.
Adults would have a path through the Affordable Care Act’s Marketplace, which will have a special enrollment period through July 2024.
“If they come to the marketplace, there's a, there's a fairly good chance they would get a plan for free. I think there's some statistic like four to five people in the country can get a plan for $10 or less.”
Why calling can be difficult
The key is understanding your status. Packham recommends checking with DCF that addresses are updated. Residents can check their status either by going online or by calling the DCF phone number. (1 (850) 300-4323)
But those lines may be overwhelmed, said Brenda Santana, CEO of a non-profit Access Center in Kissimmee.
“When you're calling DCF, it could be hours, hours, and hours waiting for one simple answer,” she said. "On top of that, the call could disconnect because the queue got overloaded. And then you have to go through the process again and look for somebody to help. There are people who could wait days and days trying to find somebody at DCF to talk to."
That’s where Access centers come in, which are organizations either staffed by DCF or licensed nonprofits that exist to help people with Medicaid and food stamps.
Sanata opened her office a year and a half ago with her husband, who died in 2021 due to COVID. Santana is the only person in the office working Monday to Wednesday. She’s overwhelmed and looking for volunteers and sponsorship so she can do it full-time.
As she waits for help, the workload is increasing.
“We get 30 to 50 calls a week. And that's just me, everything by myself," she said. I haven't touched the emails yet."
Getting information on Access centers can be tricky. For example, when calling DCF about Access centers located in Orange County, the department will list Santana's center off Hiawassee Road. However, this information is inaccurate. Santana moved to her Kissimmee location recently, but DCF hasn't updated the information.
Packham called ACCESS centers in Central Florida and found some that were no longer operating. She spoke with DCF about it, and the department said it was creating an updated list.
WMFE requested DCF for an updated list of ACCESS Centers, but the department is still processing the request.
You lost Medicaid. What now?
If you think you could lose Medicaid,
first be sure to double-check with DCF that your address is up to date by MyFloridaAccess.
Next, be on the lookout for a DCF envelope with a yellow strip to inform you of your status. This process could take up to 14 months.
If you're having trouble calling DCF, try the department's website and interact with its virtual assistant. It should be able to inform you of your status after you enter your social security number.
New job, no insurance
For those who may have received a new job during the pandemic, and didn't sign up for their job's health insurance due to having Medicaid, speak with a supervisor or human resources office and let them know of an ineligible Medicaid status.
Bring the DCF envelope and present the information to them. By law, the company must allow an employee 60 days after the loss of coverage to enroll in the company health plan.
If a company is too small to offer insurance, there's also a path of coverage through the Affordable Care Act's Marketplace health insurance, which will have a special enrollment period until July 2024.
Health insurance navigators are available to help determine which plan is best for individuals and families. Visit Covering Florida or Covering CFL to reach a navigator.
"I don't qualify for any of it"
If someone doesn't qualify for health insurance from an employer, the Marketplace, or through Medicaid, there are federally qualified health centers in Central Florida that offer people without health insurance a sliding fee scale — a reasonable amount of money to pay for visits. You can find these centers by calling 211.
For those looking to get in touch with Santana's ACCESS center, for help or to volunteer, she can be reached by phone at: 321-746-3511.
Other Access centers can be found here on Google. The My Florida Access list of centers was not available at the time of this article's release.