November 30, 2023

Health Insurance

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Medicaid enrollment dipped by 2% in June

The month of June saw about a 2% reduction in the number of residents enrolled in Medicaid, the health care safety net program for the elderly, poor and disabled. That’s a far smaller drop than what the Gov. Ron DeSantis administration was expecting.

A recently published report shows that as of June 30, there were 5,427,530 people enrolled in Medicaid as the state continues to “unwind” from the public health emergency (PHE).

That figure includes 8,287 children who are enrolled in an optional Medicaid expansion program called MediKids. Part of the state children’s health insurance program, MediKids is an optional expansion program and provides benefits to low-income children between the ages of 1 and 4. Unlike traditional Medicaid, families pay premiums for MediKids benefits.

Agency for Health Care Administration (AHCA) Deputy Secretary of Health Care Finance Data Tom Wallace told members of the Social Services Estimating Conference Committee last week that the Legislature anticipated higher disenrollment rates when crafting the Fiscal Year 2023-24 budget and, as a result, “We are over the budget by 245,000 people.”

Florida, like other states, started “unwinding” Medicaid with the end of the PHE caused by the COVID-19 pandemic. This meant it could begin removing people from the rolls. Florida health care officials anticipated about 900,000 people would be disenrolled from the program by the end of June.

Instead, about 640,000 people were dropped during that time span, according to Wallace. Over the same period, 134,000 people enrolled, making for a net reduction of enrollment of about 500,000.

Most Medicaid recipients are enrolled in what’s known as the statewide Medicaid Managed Medical Assistance (MMA) Program, which saw a 3.55% reduction in enrollees, dropping from 4,323,712 at the end of May to 4,170,084 as of June 30.

But there were enrollment increases in other smaller Medicaid program areas. For instance, the LTC program saw a slight increase (less than 1%) in enrollment. There also was an increase (3%) in the number of beneficiaries who aren’t required to enroll in the MMA or LTC programs and can receive their benefits outside of managed care.

These “fee for service” populations include certain Medicare beneficiaries, women in the family planning waiver program, pregnant women, children in emergency shelter care, Department of Juvenile Justice clients, and the Medically Needy program, which can help pay for Medicaid-covered service for people suffering from catastrophic illnesses who accumulate large monthly medical bills.

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. After Florida took advantage of a Medicaid extension, so can postpartum women for up to one year following their delivery.

For the elderly and disabled, the income eligibility is set at 88% of the federal poverty level.

Most of the Medicaid beneficiaries in June (71%) qualify for Medicaid because of the Temporary Assistance for Needy Families (TANF) program. To qualify for TANF in Florida, families must have a very low income.

For children aged 1 through 18, that threshold is 133% of the federal poverty level. Of the 3,861,384 TANF-eligible Medicaid enrollees in June, 63% were under the age of 18, according to the June enrollment report.

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