STORIES
STORIES
Medicaid | The Lived Experience:
Unwinding the Continuous Coverage Requirement
After the pandemic-related Medicaid continuous coverage requirement ended March 31, 2023, the Department of Children and Families (DCF) began redetermining the eligibility of Florida’s enrollees and sending termination notices to those deemed no longer eligible or who failed to complete their renewal within 30 days. The notices are extremely confusing and often lack adequate explanation as to why DCF determined the person(s) to be ineligible, some terminations are clearly erroneous, and people are generally unaware of their right to appeal or how to do so. The personal narratives below, as well as multiple stories in national and state media, illustrate how Florida’s redetermination process is hurting vulnerable children and families.
At Least 2 Million Children Have Lost Medicaid Insurance This Year
Many of the children were eligible for federal aid, experts said, but errors have been common as states “unwind” assistance from earlier in the coronavirus pandemic. Christina describes the harm caused to her family after her kids were erroneously terminated from Medicaid twice.
The Biden Administration Is Slow To Act As Millions Are Booted Off Medicaid
Up to 30 million of the poorest Americans could be purged from the Medicaid program, many the result of error-ridden state reviews. Lily and her FHJP lawyer describe how the state erroneously terminated Lily‘s Medicaid on 2 different occasions.
Hundreds of thousands of children are being kicked off of Medicaid
Once they lose Medicaid –even if still eligible– “regaining coverage can be frustrating and time-consuming. Over several weeks, Tanya spent hours on hold trying to restore her kids’ insurance."
Class action challenges Florida’s termination notices
Over 182,000 Floridians have been sent incomprehensible termination notices. FHJP and NHelP allege that many have no idea if the State is making the right decision and whether (or how) to challenge the termination if they think it is wrong.
Millions may soon lose Medicaid
Under Florida’s Plan, children with complex medical needs like Penelope were supposed to have their redeterminations postponed until the end of the Medicaid “unwind” period.
Florida declining help with Medicaid unwinding
The federal waivers aim to reduce the risk of eligible families losing Medicaid coverage due to procedural errors.
Staggering numbers of Americans lose coverage
Since pandemic protections ended on April 1, those initially losing coverage include Florida children with complex medical conditions. FHJP is helping them.
Florida Medicaid changes leave some scrambling
Florida has purged kids younger than 21 with medically complex conditions until next spring, a variation from their plan for Medicaid redeterminations.
The STORIES, Media and Information
Seminole, FL
After struggling with Parkinson's, Michael was finally enrolled in Florida’s Long-Term Care Waiver program in 2022, allowing him to receive needed services at home. But just a year later, his Medicaid was improperly terminated, resulting in the loss of his essential in-home services and thousands of dollars in out-of-pocket expenses for his family.
Citrus County, FL
When a profoundly disabled young man was about to be wrongfully terminated from Medicaid, his stepmother quickly filed a pre-termination appeal. This ensured there would be no interruption in his life sustaining nursing services; but the termination never should have happened.
Jackson County, FL
Laurie’s son, who has type 1 diabetes, cannot lose health insurance. His Medicaid was not scheduled for redetermination until March 2024. But she got a confusing notice in September 2023 saying her son would lose Medicaid at the end of the month, and she's spent panicked days trying to ensure his ongoing coverage.
Orange County, FL
Thanks to continuous Medicaid coverage throughout the COVID-19 pandemic, Carlos was able to receive treatment and medication for his back injury and depression. Now, that is ending and Carlos will no longer have access to the health care coverage he needs because Florida does not make coverage available to low-income parents like him.
Milton, FL
Melissa had Medicaid since the spring of 2020, but then her providers began charging copayments she could not afford, and her notices made no sense.
Orlando, FL
Hard working students and youth could face the loss of needed health coverage. Once the Public Health Emergency ends, Florida residents like Iris, a college student with asthma, could lose access to affordable healthcare needed for life-saving medications.
Hollywood, FL
S.T. and her family are living on the edge, hanging on to their family’s Medicaid health insurance amid the COVID-19 pandemic, living in fear of losing the healthcare that keeps them alive.
July 1, 2023
Under Florida’s Plan, children with complex medical needs like Penelope were supposed to have their redeterminations postponed until the end of the Medicaid “unwind” period. (April 2024). But some parents of gravely ill children have suddenly learned that their child’s Medicaid had ended. Fortunately, the Florida Health Justice Project’s was able to help Penelope get back on Medicaid.
August 23, 2023
The lawsuit, which was filed as a class action by Florida Health Justice Project and the National Health Law Program, challenges the notices used to alert people that their Medicaid coverage is ending. As alleged in the suit, low-income individuals who are losing Medicaid coverage have no idea if the State is making the right decision and whether (or how) to challenge their loss of coverage if they think the termination decision is wrong.
Read Declarations from Plaintiffs: Chianne D., Jennifer V.
April 10, 2023
The video and portal materials have been created as a training tool and resource for legal services staff, navigators, and others who are assisting recipients during the “unwinding” of the pandemic-related continuous Medicaid coverage requirement.
April 20, 2023
Medicaid is complicated, and recipients who receive a termination notice may be confused. The Florida Health Justice Project (FHJP) can provide Medicaid eligibility assessments, including whether the termination notice appears (in)correct and the client's legal rights. For clients who want to be referred to FHJP, please complete this form (English) or this form (Español) and hit the Submit Button.
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Relying On Medicaid
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Making The Case For
Medicaid Expansion
The Florida Health Justice Project speaks with Dr. Olveen Carrasquillo, a leading Miami physician, about the challenges faced by his many uninsured patients and the devastating impact of Florida’s failure to expand Medicaid.
Why Floridians Are Falling
Through The Coverage Gap
Florida is one of only 14 states that have not expanded Medicaid. As a result, approximately 445,000 Floridians fall into the “Coverage Gap,” meaning they have no path to affordable coverage
Florida's Health Care Coverage Gap
Florida's Health Care Coverage Gap
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The Florida Health Justice Project, a nonprofit organization, recognizes that access to quality and affordable health care is a human right and engages in comprehensive advocacy to expand health care access and promote health equity for vulnerable Floridians.
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