TALLAHASSEE — Nearly 600,000 children in Florida were placed on government-provided care after the federal government lifted the coronavirus-related national health emergency last year, according to a new report from the Georgetown Center for Children and Families. They lost more health insurance than any other state except Texas. .
The report is a national study of how states pulled children off Medicaid after the federal government lifted a hold that had blocked Medicaid patients' withdrawals during the pandemic. Through December, it was found that 589,671 children had been lost to state-run government health insurance programs.
Total child enrollment in April 2023 was 3,093,191. In December, the number decreased to 2,503,520.
The report's authors call into question Florida's efforts to prevent children from becoming needlessly uninsured, saying it is unclear whether these children found health insurance elsewhere. It is said that it is unknown.
“We don't know how many of these children are currently uninsured or uninsured, but there are many reasons to be concerned,” said the report's lead author, Georgetown University Children's Center. said Joan Alker, Executive Director of. and family, at a news conference Thursday.
On Friday, the Florida Department of Children and Families strongly criticized the findings, saying the state has diligently reviewed eligibility, processed nearly 5 million cases, and received responses from 9 out of 10 patients. He said there was. Mallory McManus, deputy chief of staff for the state Department of Children and Families, also said new enrollments in KidCare, the collective name for the Affordable Care Act marketplace program and the state's children's health program, have spiked in the last year.
“The idea that Florida failed this process is false,” McManus said. “States found to be non-compliant are required by the (federal Centers for Medicare and Medicaid Services) to pause the process until the issue is resolved.Florida is by no means one of those states. There was no.”
Although the state disputes the report's conclusions, the study found a large drop in patients from government health programs nationwide.
Overall, the number of children enrolled in government-subsidized health insurance programs, Medicaid and the Children's Health Insurance Program (CHIP), fell by 4.16 million nationwide during this period, the report said. Florida and Texas combined accounted for 38% of that decline, the report said.
During the coronavirus pandemic, the federal government prohibited states from excluding people already enrolled in Medicaid. Since that mandate ended last April, Florida and states across the country have been reevaluating whether Medicaid patients are still eligible. (Florida is one of 10 states that refused to expand Medicaid to the working poor, so Medicaid primarily targets pregnant women and children.)
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But this reassessment, known as “Medicaid rollback,” has generally been fraught with problems, with 70% of Medicaid patients nationwide losing coverage since the rollback began, according to the nonprofit health policy group KFF. It is estimated that he lost. Removed for procedural or bureaucratic reasons.
Alker said federal researchers found that “three-quarters of children who lose or have lost Medicaid during the mitigation period” are eligible to gain health insurance through the program, but “for procedural reasons or It is estimated that they have lost their insurance due to procedural reasons.'' These reasons may include not receiving your renewal documents on time.
“This means that the renewal process has somehow broken down,” Alker said.
problem of effort
Since the federal government last year allowed states to begin reevaluating eligibility and requiring beneficiaries to renew coverage, it has created a set of optional tools states can use to smooth the process. These tools include ways to increase automatic renewal of coverage, update enrollee contact information, and give insurance companies that administer Medicaid greater latitude in assisting patients through the process. Ta. A separate report released Thursday by the Urban Institute found a “particularly significant association” between the number of tools states implemented and the number of children retained in government health insurance programs after mitigation began. It was shown that
Florida is the only state in the country to refuse to adopt these tools, according to the federal program Centers for Medicare and Medicaid Services.
On Dec. 18, U.S. Secretary of Health and Human Services Xavier Becerra sent a letter to DeSantis stating that Florida has “increased the number of children who lost Medicaid and CHIP coverage since fully renewing eligibility for the Medicaid and CHIP programs.” “It's one of the nine states with the most or the highest percentage.” We restarted this spring. ”
Becerra laid out “several strategies” the DeSantis administration could employ to ensure Florida's children are not excluded from coverage due to “red tape” or other avoidable reasons. These strategies include implementing some of the optional tools described above, as well as removing barriers to enrolling children in the Children's Health Insurance Program and expanding Medicaid coverage to the working poor. Ta.
But McManus, deputy chief of staff for the state Department of Children and Families, disputed that Florida is allowing children to slip through the cracks.
“For people who have been 'procedurally removed,' or unresponsive, the Department of Children and Families may contact them up to 13 times by phone, mail, email, or text message before proceeding with the removal process,” McManus said. We also reached out to them and went above and beyond.” “Florida has one of the lowest deregistration rates in the nation and is well below the national average.”
McManus said 93% of families with children with “medically complex conditions” have been reached, and the state has established a dedicated Medicaid line for beneficiaries with an average wait time of less than five minutes. .
“We not only complied with all of the federal requirements; we exceeded them,” McManus said. “It is difficult to fathom what further steps the country could take beyond the thorough measures already in place to support these people through the process.”
The Florida Health Justice Project is suing the secretaries of the Florida Department of Children and Families and the Agency for Health Care Administration in federal court, alleging that the state's redetermination process violates patient due process. A jury trial is scheduled for May 13 in Jacksonville.
Where did the dropped patients seek health insurance?
McManus told the Times/Herald that as of last month, 182,000 children were enrolled in Florida KidCare, an increase of 66% since the federal government lifted the federal health emergency. Ta. She also said she has seen a 50% increase in the number of children enrolled in plans through the Affordable Care Act Marketplace.
However, Alker said enrollment in the Affordable Care Act marketplace, where low-income families can purchase insurance with government subsidies, has increased enrollment in children's Medicaid and Children's Health Insurance Programs nationwide. It said it would only offset the decline by 14%.
He said enrollment in a separate children's health insurance program for households with slightly higher incomes would only offset 10% of the drop in children nationally. Alker said the number was slightly higher in Florida, where 12% of children who lost coverage from Medicaid and the Children's Health Insurance Program were enrolled in another program, according to separate data as of March.
“So these are reasons to worry that children in states with high Medicaid numbers and rates will be uninsured, at least for some period of time,” Alker said. “These states should seek to reach out to families with trusted community-based partners and resources to re-enroll eligible children and consider system reforms to make the process smoother. be.”
Alker largely blamed the governor for children potentially becoming uninsured after mitigation begins. That's because the governor runs the government's health insurance program. But McManus said an objective reading of the state's efforts would lead to the opposite conclusion.
“The fact is that Florida has fought to give more children access to (Children's Health Insurance Program) coverage,” McManus wrote. “In June 2023, Governor Ron DeSantis signed a bipartisan bill expanding the income eligibility requirements for the Florida Kidcare Program from 200% to 300% of the federal poverty level, allowing Florida to provide an additional 68,000 children. of uninsured children. To date, however, the Biden administration has not yet approved Florida's CHIP expansion.”
