The political fight over states clearing their Medicaid rolls has reached a federal courtroom after an advocacy organization sued Florida Tuesday.
According to the most recent data, Florida removed 408,000 people from Medicaid coverage in April and May, more than half of whom lost coverage not because the state determined they didn't qualify but for procedural reasons, such as authorities being unable to reach them, according to state reports analyzed by KFF.
The National Health Law Program filed the lawsuit on behalf of three Floridians in the U.S. District Court for the Middle District of Florida and intends to seek class-action status potentially to represent more than 182,000 residents, said Sarah Grusin, a senior attorney at the organization.
The lawsuit argues that Florida violated federal law by failing to sufficiently notify enrollees that their Medicaid coverage was ending or to give them information on how to appeal. The plaintiffs tout the case as the first legal action in response to Medicaid redeterminations this year.
“Plaintiffs and class members are losing Medicaid coverage without meaningful and adequate notice, leaving them unable to understand the agency’s decision, properly decide whether and how to contest their loss of Medicaid coverage, or plan for a smooth transition of coverage that minimizes disruptions in necessary care,” the plaintiffs' complaint says.
The Medicaid redeterminations process is intended to remove people who no longer qualify for benefits but were permitted to remain enrolled during the COVID-19 public health emergency. But the Centers for Medicare and Medicaid Services, Democratic members of Congress and others have expressed alarm at the sheer number of beneficiaries losing coverage in Florida and elsewhere—and that procedural reasons, not ineligibility, are the most common reason.
As of Monday, KFF estimates that 5.2 million people have been expunged from Medicaid in the District of Columbia and the 45 states for which data are available. Procedural reasons accounted for 74% of those disenrollments, according to KFF.
The defendants are Florida Agency for Health Care Administration Secretary Jason Weida and Florida Department of Children of Families Secretary Shevaun Harris. In identical statements, the two agencies rejected criticism of how Florida is handling Medicaid redeterminations.
“This is a baseless lawsuit, and while the state cannot comment on pending litigation, we offer the following indisputable facts: Our letters to recipients are legally sufficient," the statement says. "In fact, CMS approved the department’s redetermination plan based on their regulations. There are multiple steps in the eligibility determination process and the final letter is just one of multiple communications from the department. Our department continues to lead on Medicaid determinations and being fiscally responsible.”
According to CMS, Florida is the only state that has not taken advantage of federal flexibilities such as partnering with Medicaid insurers to collect income and eligibility information.
The plaintiffs want the court to restore Medicaid to those who lost benefits and to issue an injunction forbidding Florida from continuing Medicaid redeterminations until it amends the notification and appeals systems. “The state should fix their notices. They've known since at least 2018 that the notices are problematic, and they should take steps to put in more accurate and complete information,” Grusin said.
The National Health Law Program aims to represent a class of current and former Florida Medicaid enrollees who received written notices since March that did not specify why their coverage was ending. The organization also wants to include beneficiaries to whom Florida sent letters informing them their benefits would end because their incomes were too high but did not detail what the state's rules are or how much the state believes they earn.
