Health policy experts are highlighting a multitude of concerns regarding Florida's Medicaid Redetermination process, claiming it results in a lack of coverage for eligible children and families.

During a media call on Tuesday, advocates argued despite the Florida Department of Children and Families' stated plan to manage the unwinding of the public health emergency, the reality has been marked by chaos and confusion.

Official data released in late July by the U.S. Centers for Medicare and Medicaid Services show in the first month after federal continuous coverage provisions for Medicaid ended, 249,427 Floridians were disenrolled, 82% of whom had their cases closed for procedural or "red tape" reasons, such as failure to respond to a notice.

Erica Monet Li, policy analyst for the Florida Policy Institute, said the state's call center wait time ranks among the worst of the 17 states initiating redeterminations in April.

"48% of the calls made to DCF were abandoned and the average wait time for an initial contact was 40 minutes before being pushed to another helpline," Monet reported.

The Florida Department of Children and Families has issued guidance on its website, however, advocates say some links to legal aid are not working, language translation from English to Spanish is confusing and needs improvement, and they said the website needs to be modernized with a mobile-friendly option to make it easier for Floridians to navigate.

According to the Centers for Medicare and Medicaid Services, every state must unveil a strategy to streamline re-enrollment and reduce coverage losses.

Joan Alker, executive director of the Georgetown University Center for Children and Families, noted a mechanism called "ex-parte" renewals, intended to simplify income-based verification and auto-renewals, is only being implemented in Florida at approximately 19%.

She expressed concern the state's processing methods might warrant investigation.

"Because Florida has a low ex-parte rate and a relatively high share of children, certainly Florida may be one of the states that is being investigated for this issue and we expect CMS enforcement to follow," Alker noted.

Advocates said it is difficult to navigate such a complex process and are calling on Florida officials to issue a pause in redeterminations until they fix the problems or able to properly execute the state's plan.

Lynn Hearn, staff attorney for the Florida Health Justice Project, which has a dashboard on its website for tracking the redetermination process, said the group is hearing many stories of people being confused about notices from the state.

"The notice also does not clearly indicate how to appeal or correctly," Hearn asserted. "The appeal instructions are deep in the notice, after a multipage notice, after a full page of QR codes for potentially other irrelevant other programs."

Florida is the only state to not take advantage of the flexibilities offered by the Centers for Medicaid to remedy common issues and the groups are urging Florida's leaders to focus on fixing current problems to ensure the state's eligible children and families are not cut out of any needed coverage.

After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


get more stories like this via email

New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.