Florida Medicaid enrollment inches closer to 5 million

Florida’s Medicaid enrollment continues to inch closer to the 5 million mark.

Information posted to the Agency for Healthcare Administration website shows there were 4,917,093 people enrolled in the Medicaid program at the end of August. That’s about a 1% increase from the previous month.

State economists met in July and August to discuss Florida Medicaid enrollment and costs for the current fiscal year, which ends June 30, 2022. Economists from the Governor’s office and the House and Senate agreed Medicaid enrollment would grow to 5,042,246 by next summer.

That means if the enrollment projections are accurate, more than one in five Floridians will be on the program by June 30, 2022. The cost of caring for the 5-million plus people will amount to nearly $34.9 billion, economists estimate.

There are 11 different Medicaid service regions across the state. 

Florida has a Medicaid managed care mandate, meaning most of those people are enrolled in a Medicaid HMO or some other type of managed care plan. Florida has contracts with managed care plans in those regions. The number of plans allowed in those contracts is set in statute.

Those people who aren’t enrolled in a managed care plan are in the Medicaid fee-for-service program.

Meanwhile, data show Medicaid Region 11 leads the state in terms of numbers of people enrolled in the program with (819,971) beneficiaries. Medicaid Region 11 comprises Miami-Dade and Monroe counties.

Medicaid Regions 6 and 7, meanwhile, have the second and third highest Medicaid enrollments with 688,298 people and 653,240, respectively. Medicaid Region 6 includes Hardee, Highlands, Hillsborough, Manatee and Polk counties. Medicaid Region 7 includes Brevard, Orange, Osceola and Seminole counties.

While Region 11 leads the state in terms of number of Medicaid enrollees, Region 1 had the fewest number of people, 163,775, enrolled at the end of August. Escambia, Okaloosa, Santa Rosa and Walton counties make up Medicaid Region 1.

Medicaid is the health care program for the poor, elderly and disabled and is financed jointly by the state and federal governments. Medicaid is countercyclical, meaning enrollment in the health care safety net program is low during good economic times, when revenue is flowing into the state’s coffers.

But during an economic downturn, when people lose their jobs and state sales tax collections dip, enrollment in the Medicaid program increases. That puts pressure on states to finance the increased costs when the program is needed the most. 

To help offset the increased costs in Medicaid enrollment following the COVID-19 pandemic, Congress in 2019 agreed to increase by 6.2% the amount of money it provides states to help finance the program. The increase will remain in place so long as the national emergency declaration remains in effect.

While the 6.2 percent increase has helped finance the program, the increased federal financing comes with caveats. For instance, Florida Medicaid officials cannot remove anyone from the Medicaid program who was on the program prior to the start of the pandemic.

The state’s inability to remove people from the program is another reason enrollment in Florida’s Medicaid program remains high. Before the COVID-19 pandemic, enrollment in the Medicaid program was at an all- time high in fiscal year 2016-2017 when 4,017,726 people were enrolled.