STORIES
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STORIES
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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
Orange County, FL
For fifteen years, Medicaid has provided Kaylee the ability to fight the odds and thrive in spite of the severe neurological disorder she was born with. Suddenly, Kaylee’s mother Tania was informed, like so many other parents of medically complex children in Florida, that on Easter Sunday her daughter would be losing the healthcare coverage that has been her lifeline.
December 2023
This video, the second is a 2-part series, features lawyers from the National Health Law Program and the Florida Health Justice Project explaining why they filed a class action challenging Florida’s Medicaid termination notices; why the issues are so important; who the Plaintiffs are; and what brought this litigation team together.
December 2023
This video, the first in a 2-part series, tells the story of Floridians struggling with Florida’s Medicaid unwind problems. Their lived experiences include dealing with unintelligible notices; an unavailable call center; uninformed staff; medically complex kids prematurely cut off and erroneous terminations.
Palm Beach County, FL
After a sudden termination, a mother successfully fought to have her medically complex five year old reinstated on Medicaid. Months later, Penelope’s Medicaid has again been cut off without notice, and her mother is struggling to get her covered before the out-of-pocket expenses pile up.
Palm Beach County, FL
After Wayne, a quadriplegic elderly man, received unexpected notice that his Medicaid would be terminated at the end of October 2023, he was unable to get answers as to why his Medicaid was ending and what if anything he needed to do to fix it. Terrified he would lose his life sustaining healthcare, he had to find a lawyer to help.
Florida
Lee County, FL
Daughter frantically seeks answers after 91-year-old mother's Medicaid disenrollment scare
Orange County, FL
Tatwayna’s child, who needs round-the-clock nursing care, was suddenly and incorrectly cut off Medicaid. Tatwayna spent countless hours unsuccessfully trying to get DCF to fix the error.
December 21, 2023
This video, the second is a 2-part series, features lawyers from the National Health Law Program and the Florida Health Justice Project explaining why they filed a class action challenging Florida’s Medicaid termination notices; why the issues are so important; who the Plaintiffs are; and what brought this litigation team together. More information on the video series can be found here.
December 14, 2023
This video, the first in a 2-part series, tells the story of Floridians struggling with Florida’s Medicaid unwind problems. Their lived experiences include dealing with unintelligible notices; an unavailable call center; uninformed staff; medically complex kids prematurely cut off and erroneous terminations.
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.
January 17, 2024
This Toolkit is intended to help Medicaid recipients and their advocates better understand the termination notice, determine whether an appeal is appropriate, and navigate the appeal process.
Read STORIES Of Other Floridians
Relying On Medicaid
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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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