medicaid redeterminATIONS Background
The Families First Coronavirus Relief Act of 2020 allowed states to receive a 6.2 percentage point increase in their federal matching rate for Medicaid. As a condition, states were not allowed to disenroll individuals who were otherwise determined ineligible for Medicaid. This, in turn, increased the number of individuals on the Medicaid rolls. As of March 2023, there were 5.75 million Floridians enrolled in the Medicaid program.
The Consolidated Appropriations Act (CAA) of 2023 allowed states to restart eligibility redeterminations as early as February 1, 2023, with disenrollment beginning on April 1, 2023. States continue to have access to enhanced federal funds throughout 2023 on a phased-down basis if they meet certain requirements related to the redetermination process. The 6.2 percentage point increase in the federal matching rate will be reduced in three stages. The increase will drop to 5 percent in April−June 2023, to 2.5 percent in July−September 2023, and to 1.5 percent in October−December 2023. It is important to note that states have until June 20, 2024, to complete the PHE unwinding-related eligibility redeterminations.
A key item to remember is that individuals who are determined to no longer be eligible for Medicaid due to changed circumstances will be referred automatically to alternatives, including the Federal Marketplace, Florida KidCare, the Medically Needy program, or other subsidized federal health programs.
FHA Education and Member Engagement
FHA has been consistently engaged with the Department of Children and Families (DCF) on the unwinding of the COVID-19 public health emergency (PHE) that requires states to resume normal eligibility redeterminations operations for the first time in nearly three years. We hosted a statewide webinar with DCF to go through the redetermination calendar, discuss priority groupings, and confer on the automatic referral process. We also hosted a statewide webinar with Covering Florida about the state’s insurance health care navigator program. We have also developed member resources that can be used to help patients navigate alternative coverage options. We encourage hospitals and health systems to utilize these resources to assist individuals who may need assistance with coverage if they no longer qualify for Medicaid.
FHA Member Resources
Medicaid Redetermination Process Part 1 – DCF Redetermination Process
Medicaid Redetermination Process Part II – Continuous Insurance Coverage