Gov. DeSantis administration quietly alters Medicaid policies to comply with federal law

The Gov. Ron DeSantis administration — which has made national headlines for its opposition to President Joe Biden’s health care proposals — quietly announced last week its plans to comply with new Medicaid policies to extend health care coverage to poor and low-income children and to ensure federally approved vaccines are covered.

The Biden administration advanced the policies. Copies of the state amendments — which were sent to the federal government for approval — are not posted on the state’s Medicaid website. Florida Politics requested copies of the state amendments but the Agency for Health Care Administration (AHCA), which houses the state’s Medicaid program, did not respond to requests by press time.

State Medicaid officials announced on Dec. 26 that they were sending the amendments to the Centers for Medicare & Medicaid Services (CMS) for approval. One amendment ensures that effective Jan. 1, children under 19 years old who qualify for Medicaid will have coverage for 12 months without having to take steps to requalify for the safety net program.

Before the change, Florida policy was to provide 12 months of Medicaid eligibility for children under 5 years old. Eligibility for older children (5 through 19) has been limited to six months, which means they must resubmit paperwork to the state to continue to qualify for Medicaid coverage.

Now, children under 19 who are determined eligible for the program will qualify for 12 months without having to resubmit paperwork.

While AHCA manages and administers the Medicaid program it does not determine eligibility. That is the role of the Department of Children and Families (DCF). It’s not clear that DCF has announced the policy change on its website.

According to the Dec. 26 notice, the change will bring in about $3.4 million in federal funds in the state Fiscal Year 2023-24 and about $4.5 million in federal funds for Fiscal Year 2024-25.

The second state amendment announced last week brings Medicaid and Florida KidCare (the state’s version of the federal children’s health insurance program) to cover approved adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). The amendment is retroactive to Oct. 1, 2023, when the requirement took effect according to CMS guidelines. The changes apply to the fee for service and managed care health settings.

According to the announcement, that change will result in nearly $4.8 million in additional federal Medicaid funds for Fiscal Year 2023-24 and roughly another $6.4 million in federal Medicaid funds for Fiscal Year 2024-25.