Ending the COVID-19 Continuous Medicaid Coverage Requirement: Over a million Florida Medicaid recipients are at risk of losing coverage

Background:  In the face of the  COVID-19 pandemic, 2020 legislation provided states with significant federal funding to ensure continuous Medicaid coverage of individuals enrolled in the program, even those who are no longer technically eligible. States were required to maintain this moratorium on terminations until the end of the Public Health Emergency (also referred to as the PHE). In late December 2022, the law was changed to “de-link” the requirement of continuous Medicaid from the end of the PHE. Although the PHE is still in effect, the continuous Medicaid coverage requirement ends March 31, 2023. 

Under Florida’s Medicaid Redetermination Plan, the Department of Children and Families (DCF) will begin reviewing Medicaid eligibility for approximately 4.9 million Floridians in March 2023. The reviews will be spread throughout a 12 month period.  Terminations for those who are sent case redetermination (also called “renewal”) notices in March and who are found to be ineligible or who fail to complete the renewal process will be effective April 30, 2023. DCF estimates that there are more than 900,000 cases in which one or more household members are no longer eligible.  
 
Impact of  the continuous coverage provision on Florida’s Medicaid enrollment:  Medicaid enrollment in Florida has increased by over 1.8 million between March 2020 and December 2022.  The largest rates of increase are among: 1) parents & caregivers, whose enrollment has increased by over 855,066; and 2) 19-20 year olds, where enrollment has more than tripled, going from 62,721 to 210,780. The Appendix details the increases.  

Groups most at risk of losing coverage because they are no longer Medicaid eligible: 

• Parents & Caregivers now over income or who no longer have any child(ren) under 18​
• Youth who turned 19-20
• Aged and disabled 
• Former foster children now over age 26
• Medically Needy Recipients

​Greatest impact: Those most likely to lose Medicaid eligibility are also those who experienced the highest rate of increase, i.e. parents/caregivers and 19-20 year olds. They are at risk because their family income exceeds Florida’s limit for these groups which is less than 30% of the federal  poverty guidelines, e.g. less than $ 500/month for a parent and child.

• Parents & caregivers: Many who lost their jobs in the pandemic and enrolled in Medicaid have since gone back to work.  Under normal eligibility rules, their Medicaid would have been terminated, but due to the continuous coverage requirement they remained enrolled in the program.  This has been a critical benefit, especially for those whose income remains at or near the poverty level.  Given Florida’s extremely low income limit, virtually all working parents/caregivers, along with their 19-20 year old children, will lose Medicaid after the continuous coverage requirement ends.  

 

• 19 & 20 year olds:  Critically, these youth may be able to remain on Medicaid.  There are complicated considerations for this population, and outreach is essential in order to help eligible youth maintain coverage. 

 

• Aged and disabled:  Many receiving Medicaid based on age or disability will lose Medicaid because they are now on Medicare, and they will likely need assistance with enrolling in Medicare and a Medicare Savings Program. 

Children are at risk of losing coverage due to procedural issues:  As of December 2022, approximately 2,520,342 children are enrolled in Medicaid in Florida.  While many children currently enrolled are still eligible for Medicaid or Kidcare, experts estimate a coverage loss or interruption of 18% due to administrative & procedural issues.  Thus, over 453,000 children are likely to lose coverage even though they remain technically eligible.  Experts also estimate that nearly one third of those children and young adults predicted to lose coverage are Latino and 15% are Black.

NEXT STEPS: The most important message for Medicaid recipients NOW is to update their information, including their address, on ACCESS. If you have individual client referrals, especially 19-20 year olds,  please contact Bryan Ortiz, ortiz@floridahealthjustice.org. 

​Download PDF Version here.

For questions, please contact Miriam Harmatz, harmatz@floridahealthjustice.org.
Last Updated January 2023.