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Florida TaxWatch Looks at State’s Medicaid Redetermination Plan and Options to Address the Coverage Gap

Florida TaxWatch (FTW) recently released “Florida Medicaid Redetermination,” which examines Florida’s Medicaid Redetermination Plan and options for Floridians who will no longer be covered through Medicaid, but are still below the poverty threshold.

The briefing also touches on the responsibility of the state legislature to address this “coverage gap” on behalf of the 388,000 individuals who may not have access to affordable health care.

Florida TaxWatch President and CEO Dominic Calabro weighed in on the findings.

“Throughout the COVID-19 pandemic, Medicaid enrollment increased dramatically in Florida – in just three years, it rose by more than 51 percent, while the state’s general population only grew by about four percent. But now, the public health emergency has officially ended, and provisions of continuous Medicaid coverage are unwinding, which means that the many Floridians previously covered by this program are being subject to a process to redetermine if they are still eligible,” Calabro said.

“Florida has prepared a plan to guide this redetermination process, but despite the state’s best efforts, there is a significant percentage of individuals currently enrolled in Medicaid that, after disenrollment, may not be eligible to participate in any other available options for health care. In fact, it is estimated that one in five, or 388,000, Floridians will fall into this ‘coverage gap,’ as they are adults with incomes above the state’s eligibility threshold for Medicaid, but below the poverty threshold,” he added. “Fortunately, there are still options to help close this gap for families, such as the expansion of Florida KidCare, which was passed during the 2023 Legislative Session. However, in the long run, lawmakers must decide how to address the potential reality of hundreds of thousands of Floridians not having access to affordable health care. Handling this issue in a fiscally responsible manner will not only provide access of necessary healthcare to Floridians in need, but it will also save the taxpayers of Florida hundreds of millions of dollars.

“Florida TaxWatch is dedicated to serving as a resource to the Florida Legislature as they begin to address this impending coverage gap, focusing on protecting the best interests of taxpayers and ensuring the Sunshine State is poised for continued success,” Calabro said in conclusion.

At the beginning of the COVID-19 pandemic, Congress passed the Families First Coronavirus Response Act (FFCRA), which included a “continuous coverage” provision that, in exchange for enhanced Medicaid funding, required state Medicaid programs to keep individuals continuously enrolled through the end of the public health emergency. According to FTW, the continuous coverage provision resulted in a substantial increase in the number of Medicaid enrollees when compared to pre-pandemic enrollment numbers.

FTW explains that, with the public health emergency ending in March 2023, Floridians are now subject to a Medicaid redetermination process as the continuous coverage provision ends. The state’s Medicaid Redetermination Plan seeks to ensure continuity of Medicaid coverage for eligible individuals, while promoting access to alternative health coverage providers, including Florida KidCare, the Medically Needy Program, Federally Qualified Health Centers, Federally Subsidized Health Centers, and Commercial Coverage.

However, FTW notes that many individuals who are not eligible for Medicaid or any of the other affordable healthcare options will fall into a “coverage gap.” It is estimated that approximately 388,000 of the more than 900,00 individuals who will no longer be eligible for Medicaid will fall into this coverage gap.

In the briefing, FTW analyzes three options that may help Floridians in the coverage gap:

Traditional Medicaid expansion – states that have expanded Medicaid have seen improved access and quality of health care, but while this is an increasingly popular option, it should be cautioned that it is associated with high costs and other economic risks, including increasing the federal debt.

“Non-Traditional” Medicaid expansion – this option includes relying more heavily on the private insurance market and placing an emphasis on higher enrollee cost-sharing, personal responsibility, and healthy behaviors.

Expanding eligibility criteria for other programs – the 2023 Florida Legislature acted upon this option by passing House Bill 121, which will expand KidCare beginning Jan. 1, 2024.

While FTW asserts doing nothing is not a responsive or responsible action by the state, until there is a clearer picture of the number of Floridians who remain in the coverage gap, it is difficult to suggest any specific measures to close it.

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