Confusing notices and long wait times leave cases unresolved, sometimes ending care.
Recent headlines have underscored the challenges faced by low-income Floridians as the state redetermines the Medicaid eligibility of over 4 million people. So far, the state’s process has seen over 197,000 people disenrolled from coverage for procedural reasons like failing to provide the information necessary to complete the redetermination.
In response, on Thursday, June 29, Florida Voices for Health hosted a virtual roundtable conversation with patients, parents, and providers impacted by Florida’s Medicaid unwinding and redetermination process. We explored the participants’ experiences with the process and the barriers they’ve faced to successfully resolving any issues.
In all, several prominent themes emerged from the discussion. Enrollees and providers were incredibly grateful for the coverage they and others received. Medicaid coverage during and after the pandemic helped folks to get life-saving care and achieve some level of financial stability. Tasha B. from Broward County, who relies on oxygen treatment to manage her long COVID symptoms in order to continue working and caring for her family, shared:
"I was eligible for Medicaid during the pandemic because I ended up catching COVID and I ended up losing my job. I'm still battling long COVID. Medicaid has been very good to me. I'm not gonna lie. I'm able to see my pulmonologist, my cardiologist, my primary care doctor..."
Michele B. from Duval County, who is diabetic and managing co-occurring health symptoms, added:
"It is a blessing. I've been able to get Medicaid and I had surgery in my right eye."
K.S. from Brevard County, who relies on a daily prescription to manage a chronic health condition, followed:
"Right after COVID I decided, like, I wanted it to just be more independent and be able to, you know, provide for my children more. So, I found a job and you know, I've been working, and I haven't had any problems with the Medicaid."
However, while most had received notices about the redetermination process, those notices left all beneficiaries in our roundtable confused about their eligibility and the steps required to retain coverage.
Tasha B. shared that she hadn’t received the official notice with the yellow stripe the Department of Children and Families has warned families to be on the lookout for:
“I got a notice, but I didn’t get anything with the highlight on it…the way that I received it was kind of funky because it was saying you have the Medicaid but it’s saying to renew...it was kind of confusing to me.”
"(T)he notice is kind of confusing. So, I was able to do it in time, but... the first set of pay stubs I sent them, they didn't like how I sent them. But...nothing that tells you they don't like it. So, you're left wondering, is that okay? Is it not? So, I actually had to call them.”
As Medicaid recipients reach out to the DCF call center to better understand the letters, they report encountering hours-long wait times, sudden hangups, and case workers and call center staff that are unfamiliar with their cases. Tasha B. continued:
“And when I did call DCF about everything, I was on hold for like 3 and a half hours and then the phone hung up. I called back again, this time I think 4 hours and something. I just end up hanging up. Then I called the case worker like 6 days straight but...she never returned a call. Then I finally got her, and she had no knowledge."
Tonesia C. from Duval County shared her experience:
“I got the letter on the 19th and I have not gotten through to anybody. The longest time I’ve been on hold was 3 and a half hours, then I got through to somebody and told me they would transfer me and then I got hung up on. And that was it. And I've been calling every day and I haven't been able to get through to anybody.”
Without clarity on what actions are required to retain care, some enrollees shared that they have been hesitant to update their information with DCF, fearful they will lose coverage because of a potential mistake. Michele B. explained:
" I try not to even change anything because if you have a change you may not know anything for the next 3 or 4 months and then you get a letter saying you didn't turn your information on time...When you know you did but nobody answered the phones."
Unfortunately, over 302,550 Floridians, including several roundtable participants, are already dealing with the impacts of losing coverage. K.S. told us her Medicaid was scheduled to end a few days after our roundtable and shared her fears about what happens next:
“So I'm like, what does it mean? And you know, like I'm wondering, do I need to have money ready when I go pick up my prescriptions? Are they gonna bill me or do I need to have the money ready to pay for my prescriptions? I never really got an answer.”
A mental health provider that joined the roundtable from Osceola County echoed these concerns on behalf of her patients, sharing that many in her care have lost coverage:
“I have many, many clients with these situations and it's very frustrating…it’s been very hard for patients and for providers.”
Policy analysts, advocates, and elected officials continue to call for a pause to redeterminations to ensure that the systems issues occurring in Florida are addressed. Along with a pause, state leaders should use the available temporary federal waivers meant specifically for operational challenges related to staffing shortages and outdated systems.
Individuals who have lost Medicaid coverage or are experiencing issues with redetermination are encouraged to visit Covering Florida to schedule an appointment with a Navigator. Navigators are certified assistors who provide free and unbiased guidance of health coverage options.