State estimates 1.75 million Floridians could lose benefits once state begins purging Medicaid rolls

'The worst thing we could do is create panic in this process.'

As many as 1.75 million Floridians could lose Medicaid coverage once the state begins taking steps on April 1 to return its Medicaid program to pre-pandemic levels.

Appearing before House and Senate health care panels, officials in the administration of Gov. Ron DeSantis said Florida will focus its efforts on removing 900,000 residents who no longer qualify for the program, either because they aged out, left the state, or earn too much to qualify for the safety net program for the poor, elderly and disabled.

The state will first start purging from the program ineligible beneficiaries who haven’t availed themselves to any of the health care Medicaid covers. The DeSantis administration will then focus on disenrolling ineligible beneficiaries who have been receiving care but no longer qualify for Medicaid.

“They will probably come off relatively quickly,” Florida Medicaid Director Tom Wallace told members of a Senate health care spending panel Wednesday.

After removing 900,000 ineligible people from the program, the state will begin Medicaid eligibility redetermination efforts on another 850,000 recipients who haven’t provided the state with ongoing pertinent financial information during the pandemic.

In all, 1.75 million people may lose Medicaid coverage, according to the rewinding document posted on the Department of Children and Families website.

Georgetown University (GU) Health Policy Institute Center for Children and Families Executive Director Joan Alker said she was still reviewing Florida’s 43-page plan, but noted “that’s a heck of a lot of people.”

Alker’s group last year published a report that found children in Florida are “are especially at risk” of losing their health care coverage as the public health emergency winds down and the federal government pares back requirements for states to maintain continuous Medicaid eligibility.

Overall enrollment in Florida’s Medicaid program has ballooned by 50% since spring 2020 due to the federal government’s mandate that people enrolled in Medicaid during the pandemic be provided continuous coverage.

With the passage of the 2023 Consolidated Appropriation Act, though, states can begin removing beneficiaries who no longer meet the income or asset requirements for the coverage. But states that choose to disenroll people will lose access to the 6.2% increase in federal dollars Congress agreed to provide to fund the safety net health care program.

Throughout the pandemic, Congress agreed to increase the amount of federal Medicaid matching funds by 6.2%. The 6.2% hike is phased down to 5% starting April 1. it’s further pared back to 2.5% on July 1 and to 1.5% on Oct. 1.

Wallace said that following the economic downturn in the wake of the pandemic, more than 100,000 children were transferred from the Florida KidCare program to Medicaid.

“We’d expect that some of these under 18-year-olds would transition back over to the (Florida KidCare program),” Wallace said.

KidCare is an umbrella name for a number of subsidized health insurance options based on a child’s age. Unlike traditional Medicaid, Florida KidCare has cost-sharing requirements. It is the option for children whose families are working and therefore earn too much to qualify for Medicaid.

Medicaid is a safety net health care program funded jointly by the state and federal governments. While states must adhere to certain federal law and rules, Medicaid programs are designed and operated by states.

Medicaid eligibility in Florida is determined by many factors including family circumstances, assets and income. Pregnant women can earn up to 185% of the federal poverty level and qualify for Medicaid during their pregnancy and, after Florida took advantage of a Medicaid extension, so can postpartum women for up to one year following their delivery.

The cap for Medicaid eligibility for children aged one through 18, however, is 133% of the federal poverty level. For the elderly and disabled, the income eligibility is set at 88% of the federal poverty level.

As of Dec. 31, 2022, there were more than 5.6 million people enrolled in Florida’s $36 billion Medicaid program.

Meanwhile, Alker also wonders whether the state updated its systems to reflect the new 2023 federal poverty guidelines published earlier this week. The new guidelines were adjusted to allow families to keep up with inflation. To that end, the 2023 annual poverty threshold for a family of three increased by $1,830 from $23,030 to $24,860.

“When they are checking families’ income, they have to use this new standard, which will make some of these 900,000 likely eligible now,” Alker told Florida Politics.

While Wallace predicted the state would be able to remove the 900,000 people it says are ineligible rather quickly, it will take longer to determine the eligibility for the other 850,000 Medicaid beneficiaries whose status is not clear.

The state does not know whether these individuals still qualify because they haven’t responded to the state’s ongoing efforts throughout the pandemic to continue to remain in contact and collect pertinent information.

Before Wednesday, the DeSantis administration had not publicly shared how the state planned on paring its Medicaid program back to pre-pandemic days.

But DCF Assistant Secretary for the Office of Economic Self Sufficiency Casey Penn said the administration had a well-coordinated communication plan and that the state has been working with “its industry partners.”

“The worst thing we could do is create panic in this process. We have a process. This is back-to-normal business operations. We want to make sure we communicate that clearly to individuals,” Penn told members of the House Health and Human Services Committee Wednesday. “If they are still eligible for Medicaid, they can maintain that eligibility.”

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.


  • Debby Foster

    January 19, 2023 at 9:06 am

    I’m still trying to understand why elderly and disabled people are only allowed 88% of poverty level and children 133%. Can you explain the reason for that?

    • Ruby

      January 30, 2023 at 2:07 pm

      These income thresholds are meant to distinguish individuals that need fully subsidized coverage (no co-pay, no premium) most. All children that come from households that make between 133.1% and 200% of the federal poverty-line (between $39,900 and $60,000 for a family of 4) are automatically referred to the Florida KidCare/CHIP program, which is a insurance buy-in option that offers low-cost coverage to children that do not qualify for Mediciad. Families pay premiums and co-pays that are scaled to their income. The medicaid threshold for the elderly and disabled is set at that level because Medicare should the primary route of recieving coverage for that population. Medicaid serves as a supplementary public assistance program for those that recieve Medicare, SSI, and SSRI. To summarize, the thresholds are set at that level in an attempt to prioritize Floridians that need the most assistance.

  • Paul Passarelli

    January 19, 2023 at 10:21 am

    I have a comment for all the people that think Governor Ron DeSantis, by being responsible with *TAXPAYER DOLLARS*, has some kind of vendetta against their mooching asses. — Move to Kalifornia! —

    There is absolutely nothing wrong with purging those that are no longer eligible from certain government rolls.

    I say ***KUDOS*** to the governor for directing the departments into putting their houses back in order.

    I say ***SHAME*** on those that would politicize such actions to sow Fear, Uncertainty & Doubt (FUD) in the weak-minded.

    I can’t wait to hear from my detractors on this one. (That was sarcasm.)

    • Yeah

      January 19, 2023 at 11:00 pm

      “move to California”

      You can keep your Medicaid while you watch all the people in Florida die without it lol

      • Angel

        January 26, 2023 at 7:54 pm

        No one is going to die. Stop being overly dramatic. Anyone who qualifies can still use it. Anyone on social services automatically gets it. However, if they make enough, why should they not be required to pay like everyone else??

    • RonJon Jones

      January 21, 2023 at 10:30 am

      To the guy who calls shame on people who have less than him.. it’s your selfish attitude (thats so infectious to others also with no class but who have amassed a little bit of wealth ) that is what rots america.. you’re like the brat in the sandbox that wont share his toy’s (MINE!) Yet the moment the bigger guy comes over and smashes his fist in your face to bloody your mouth and nose, you’ll be the 1st in line for a fema handout .. the level of hypocrisy of people like you is beyond vile.. selfcentered egomaniacs, narcissists, and sociopaths who care about no one but themselves.. you are what’s wrong with Florida It would stand to reason. You and the line of bigots from which you hale arent actually from the state ..? I’d say some military transplant that doesn’t reflect the values of true locals, that value real community.. not everyone on the Dole is gaming the system.. even those getting kicked off .. there is a reason we have these safety nets.. but your too much of a selfish pig to understand concepts like ‘the Greater Good’. The ideals that once made America great for everyone.. not just white collar criminals with no real value to society at large ..the amount doled out to corporate welfare and business, for bailouts, makes medicaid look like chump change.. you are a product of your own stupidity.. lay off the bratbart news.. it’s making you beyond stupid.
      The reason people (human beings) are on welfare, is because greedy self righteous people like you hoard it all for themselves with some semse of entitlement. Looking forward to seeing you in that FEMA LINE mooch.

      • Paul Passarelli

        January 23, 2023 at 1:36 pm

        you wrote: “Yet the moment the bigger guy comes over and smashes his fist in your face to bloody your mouth and nose, you’ll be the 1st in line for a fema handout”

        That’s gotta be one of the weirdest mixed metaphors I’ve read today.

  • Richard Bruce

    January 19, 2023 at 11:20 am

    Why should people who are illegible allowed to take taxpayer money? Purge the rolls. Should be done every six months.

  • Debbie Knepper

    January 19, 2023 at 3:32 pm

    Are all the children that are coming across the border being financed through Medicaid. I’m sorry, but I think the Americans should come first.

    • Ruby

      January 30, 2023 at 1:50 pm

      Under Florida stutue, an individual has to has to be a natural-born citizen, American national, or have verified legal immigration status to qualify for Mediciad or subsidized marketplace insurance. Even then, legal immigrants do not recieve as much coverage and have to meet increased elligibility requirements. For example, pregnant women who are legal immigrants do not qualify for mediciad coverage during or after pregnancy while women with citizenship status do. Policy and implementation do put American citizens first.

  • Olivia

    January 20, 2023 at 8:07 am

    Your absolutely right. Everyone who comes across the border gets medicaid, cash assistance, and housing.. but we have such a large population of homeless women and children. It’s very sad. We need to take care of our own. Starting by having affordable housing. I know people that work and are homeless but can’t afford to get into a place and pay rent. What are people supposed to do? It’s a messed up world we live in..

    • Angel

      January 26, 2023 at 7:57 pm

      Not in Florida, they don’t. Thankfully, we have smarter people running our state. If you’re able bodied and capable of work, they’ll put you to work, and just like everyone else, you’ll have an opportunity to work and depend on handouts.

  • Judith

    January 20, 2023 at 8:48 am

    I agree with a lot of the comments made by people on here. My daughters a widow and works and has 3 kids at home. yes she gets SS for her kids but it’s not much as her husband was self employed.. I see some people get more welfare then she gets . She is still paying a house payment and the food stamps don’t last all month. She appreciates the help but it’s hard these days to afford to raise 3 kids alone. I think widows with kids should come before ones that come here and didn’t work their adult lives like my daughter of 52…I worked all my life and so did my husband and I see ppl get more then she does. And i’m a widow and 71 and i don’t get bit 2(0 a month in food stamps and under 1000 a mont in SS and it’s just not right we don’t come first!!!

  • Kathy

    January 20, 2023 at 12:40 pm

    Close the borders, accept only péople who legally become American citizens. True Americans come first. Véterans. Señíórs, disabléd. Put Amériçan children on their own Medicàre!

Comments are closed.


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