On Friday, members of the Florida legislature health care conference committee reached a new agreement on retroactive Medicaid eligibility.
The committee previously considered the Senate's original proposal to reduce retroactive eligibility from 90 days to 30 days. The plan approved last week would retain 90 days of eligibility for pregnant women. For everyone else, retroactive eligibility would only cover back to the first day of the month that the application was filed.
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For parents and seniors who are uninsured and low-income, if you have a bad car wreck or fall seriously ill, there's a chance, in Florida, to enroll for Medicaid after the fact. This is called retroactive Medicaid eligibility (RME). Currently, if you qualify for Medicaid, the program will pay your medical bills going back three months.
Under this latest plan, if someone who might be eligible files on March 28th, Medicaid would only pay for coverage going back to March 1st. If an application is filed on March 4th, Medicaid will only cover expenses up to March 1st.
This uneven system turns health care into a game of chance, at best. At worst it will create additional stress in what is likely a family's most difficult moments.
Consider Florida's seniors, who account for a large amount of retroactive Medicaid spending.
For many aging individuals, the need for nursing home care can come on suddenly. For example, a fall may result in a broken hip, requiring long-term attention. A sudden need does not allow for pre-planning, but retroactive Medicaid coverage provides a 3-month window to get one's Medicaid coverage in order. According to Paying for Senior Care, nursing home care can cost between $5,050 - $10,050 a month. A 3 month bill can run $15,150 - $30,150.
The Medicaid application is extremely complicated, and the current three-month window does not allow a family the luxury of taking their time completing the application. Even with the retroactive eligibility period, a family must be organized and driven to arrange their paperwork and complete an application within that time frame.
Now patients and their families will have to race to complete complex Medicaid applications while hoping it coincides with a later date in the month. Ultimately, hardworking families and community hospitals will be left bearing incredible costs.
These and other efforts to cut Medicaid are happening while legislators look for ways to save money in a tight budget year. However, the $98 million saved by cutting retroactive eligibility would be more than recovered if the state chose to implement Medicaid expansion. According to the Florida Policy Institute, Medicaid expansion would save the state budget over $500 million this year alone.
Florida's electeds have a long way to go to protect its most vulnerable citizens, but they can start by not making the problem worse.
A final budget will be decided by House Speaker Richard Corcoran, R-Land O’ Lakes, and Senate President Joe Negron, R-Stuart. They are trying to finalize a 2018-2019 budget this week, which would allow the annual legislative session to end as scheduled March 9.
Your voice matter this week!