Families sue Florida after being kicked off Medicaid during state ‘unwinding’

A pair of consumer advocacy groups filed a lawsuit Tuesday alleging Florida is ending people’s Medicaid coverage without proper notice.

The groups are representing a mother and her two-year-old with cystic fibrosis living in Jacksonville, and a one-year-old in Miami. 

The lawsuit, filed in U.S. District Court in Jacksonville, claims the child with cystic fibrosis missed weeks of medication after the entire family was removed from Medicaid. The child in Miami missed a routine vaccination appointment after the doctor’s office called the day before to tell her mother she was uninsured.   

The filing asks a federal court for a permanent injunction to require the state to stop terminating Medicaid for enrollees in Florida until “adequate notice and an opportunity for a pre-termination fair hearing has been provided.”

The Florida Health Justice Project and the National Health Law Program said they believe this is the first lawsuit to challenge a state for improperly removing people from Medicaid since states began the “unwinding” process in April.

Federal legislation passed during the pandemic gave states extra money for Medicaid, but only if they kept people continuously enrolled in the program.

Before the pandemic, people churned in and out of Medicaid for various reasons. Participants lost their coverage if they earned too much or didn’t provide the information needed to verify their income or residency.

But during the public health emergency period, income changes or missed paperwork didn’t matter. If someone was enrolled in Medicaid in March 2020, or if they became eligible at any point during the pandemic, they remained eligible the entire time.

As a result, Medicaid enrollment grew more than 30 percent and covered more than 90 million people. 

But Congress ended those protections, and states have been able to reassess eligibility and kick people off Medicaid rolls since April. Nationwide, more than 5.2 million people have been disenrolled across 45 states and the District of Columbia, according to health policy research group KFF, which is tracking state disclosures.

According to KFF, Florida has disenrolled more than 400,000 people, mostly children and low-income parents, because the state has not expanded Medicaid.

More than half of those had their coverage terminated for “procedural reasons,” meaning missing or incorrect paperwork, or when the state has outdated contact information. 

The lawsuit describes dense and confusing notices sent to both families that were multiple pages long and contained conflicting information. It alleges the plaintiffs did not understand why they were losing coverage, and were not aware of any appeal options or other coverage opportunities. 

“Plaintiffs and class members are losing Medicaid coverage without meaningful and adequate notice, leaving them unable to understand the agency’s decision, properly decide whether and how to contest their loss of Medicaid coverage, or plan for a smooth transition of coverage that minimizes disruptions in necessary care,” the complaint stated. “Without Medicaid coverage, Plaintiffs are unable to obtain care they need, including prescription drugs, children’s vaccinations, and postpartum care.”

 “Our letters to recipients are legally sufficient,” a spokeswoman from the state Department of Children and Families told The Hill. “There are multiple steps in the eligibility determination process and the final letter is just one of multiple communications from the Department.

Our Department continues to lead on Medicaid determinations and being fiscally responsible.”