Trial begins in case to force Florida to reinstate Medicaid patients who lost coverage
A trial with sweeping implications for Florida’s government healthcare system is set to begin Thursday in a federal, class-action lawsuit filed by Medicaid patients who say they were illegally cut off from their healthcare by the state.
At issue is whether the state has been violating patients’ constitutional rights to due process and to a fair hearing under the federal Medicaid Act when notifying them that they are no longer eligible for the government-subsidized health insurance program.
The case is being brought by three children and two adults who say the standardized notices they received from the state failed to adequately explain why they were being cut from Medicaid and didn’t offer them a fair chance to prove they were still eligible before their coverage was terminated. They are asking a judge to automatically reinstate all Medicaid patients who improperly lost their coverage since the federal government lifted a pandemic-related hold last April that blocked states from kicking patients off Medicaid — a process known as the “unwind” — and force the state to reissue their determinations in a way that would pass muster.
“We know that people who receive Medicaid in
Li said Medicaid notices “are difficult to understand, don’t always reach the recipient on time, and then individuals struggle to receive the proper help.”
“This lawsuit reflects the stories of Floridians who have lost coverage because of this,” said Li. “And it is a big deal due to its ability to potentially hold the state agencies accountable in the wake of massive coverage loss over the last year.”
Attorneys for the plaintiffs declined to comment. The deputy chief of staff for the
In its answer to the plaintiffs’ complaint, the state acknowledged it uses “uniform language” in issuing coverage termination notices to Medicaid enrollees but otherwise denied the allegations.
The outcome of the case has implications for hundreds of thousands of patients booted from Medicaid by the state over the last year. If the judge rules in favor of the plaintiffs, patients who have been deemed ineligible for exceeding Florida’s strict income requirements since federal COVID-related protections ended last spring could be reinstated, at least temporarily.
Because
Still, the COVID-related protections allowed the program to swell during the pandemic, in part by allowing potentially ineligible patients to remain on the rolls due to the federal COVID-protections.
Between
Last April, the state began terminating Medicaid coverage for patients through the “unwind.”
The majority of these patients were dropped for procedural or red-tape reasons, and may still be eligible for Medicaid. But more than 650,000 of these patients lost their coverage because they were determined to be ineligible, per KFF. A subset of these patients is at the center of the lawsuit.
This is the only lawsuit in the nation to date related to the Medicaid unwind, the National Health Law Program told the Herald/
“The case is a very important one because it exposes deficiencies in the state’s process that predated unwinding,” said Alker.
©2024 Miami Herald. Visit miamiherald.com. Distributed by Tribune Content Agency, LLC.
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