Ending the COVID-19 Continuous Medicaid Coverage Requirement: Approximately 300,000 Miami-Dade County 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.

En 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 over 12 months.  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.

Impact of ending the continuous coverage provision on Miami-Dade County (MDC)’s Medicaid enrollment:  Medicaid enrollment in MDC has increased by approximately 343,076 (52% increase) between March 2020 and March 2023. The largest rate of increase is among: 1) parents & caregivers, whose enrollment has increased by 203,930 (294%); and 2) 19-20 year olds, where enrollment has more than tripled, going from 8,834 to 34,921 (295%). The Appendix details the increases.

Grupos con mayor riesgo de perder la cobertura porque ya no pueden optar a Medicaid:

• Padres y cuidadores ahora por encima de los ingresos o que ya no tienen hijos menores de 18 años
• Menores de 19 años cuyos ingresos familiares han aumentado
• Jóvenes que cumplieron 19-20 años
• Ancianos y discapacitados y Beneficiarios con necesidades médicas
• Antiguos hijos de acogida mayores de 26 años

​Greatest impact: Those most likely to lose Medicaid are also those who have experienced the highest rate of enrollment increase– 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 one child.

• Parents: Many parents who lost their jobs in the pandemic and enrolled in Medicaid have since gone back to work. Under normal eligibility rules, they would have lost eligibility when they went back to work; but due to the continuous coverage requirement, they remained on Medicaid. This has been a critical benefit, especially for those whose income remains at or near the poverty level. After the continuous coverage requirement ends, virtually all working parents, along with their children aged 19-20,  will lose Medicaid.

• 19 & 20 year olds:  Critically, these youth may be able to remain on Medicaid if they apply as a household of one (1). There are complicated considerations for this population (described aquí), y la divulgación es esencial para ayudar a los jóvenes que cumplen los requisitos a mantener la cobertura. Este folleto proporciona información de referencia.

• 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 at risk of losing coverage due to procedural issues:  As of March 2023, 362,258 children are enrolled in Medicaid in MDC. 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, in MDC, approximately 65,000 children are likely to lose coverage even though they remain technically eligible. Experts also note that children and young adults will be disproportionately impacted, and that nearly one third of those predicted to lose coverage are Latino and 15% are Black.

NEXT STEPS: The most important mensaje para los beneficiarios de Medicaid AHORA es actualizar su información, incluida su dirección, en ACCESS. Si usted tiene referencias de clientes individuales o le gustaría unirse a un listserv para las actualizaciones, por favor póngase en contacto con nuestro equipo a través de correo electrónico (help@floridahealthjustice.org).