A lawsuit has been filed by a pair of consumer advocacy groups, alleging that Florida is terminating people’s Medicaid coverage without proper notice. The lawsuit represents a mother and her two-year-old with cystic fibrosis in Jacksonville, as well as a one-year-old in Miami.
The lawsuit, which was filed in U.S. District Court in Jacksonville, claims that the child with cystic fibrosis missed several weeks of medication after the entire family was removed from Medicaid. The child in Miami also missed a routine vaccination appointment after the doctor’s office informed her mother the day before that she was uninsured.
In the filing, the groups request a permanent injunction from the federal court, demanding the state to cease terminating Medicaid for enrollees in Florida until they provide adequate notice and an opportunity for a fair pre-termination hearing.
The Florida Health Justice Project and the National Health Law Program believe that this is the first lawsuit challenging a state for inappropriately removing people from Medicaid since the “unwinding” process began in April.
During the pandemic, federal legislation granted states extra funding for Medicaid, with the condition that they maintain continuous enrollment for participants. Prior to the pandemic, people frequently lost Medicaid coverage due to factors such as income changes or failure to provide required information to verify their income or residency.
However, throughout the public health emergency, income changes and missed paperwork were disregarded. Anyone enrolled in Medicaid in March 2020 or became eligible at any point during the pandemic remained eligible throughout the entire period.
As a result, Medicaid enrollment increased by over 30% and covered more than 90 million people. Nevertheless, these protections were discontinued by Congress, allowing states to reassess eligibility and remove people from Medicaid rolls since April. According to research by health policy group KFF, over 5.2 million individuals have been disenrolled across 45 states and the District of Columbia.
In Florida, more than 400,000 people, predominantly children and low-income parents, have been disenrolled due to the state’s failure to expand Medicaid.
Over half of those individuals had their coverage terminated for procedural reasons such as missing or incorrect paperwork, or outdated contact information. The lawsuit describes the dense and confusing notices sent to the families, which were multiple pages long and contained conflicting information. It claims that the plaintiffs did not comprehend the reason for losing their coverage and were unaware of any options for appeal or alternative coverage opportunities.
The complaint states, “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. Without Medicaid coverage, Plaintiffs are unable to obtain the care they need, including prescription drugs, children’s vaccinations, and postpartum care.”
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