Two families based in Florida have initiated a class-action lawsuit against the Florida Agency for Health Care Administration (AHCA) and the Florida Department of Children and Families (DCF). The suit alleges that officials are terminating ‘tens of thousands’ of residents’ Medicaid coverage, without providing ‘adequate individualized written notice.’
States, including Florida, have resumed determining eligibility for Medicaid enrolment following the culmination of the continuous enrollment provision invoked during the Covid-19 pandemic. This ended on March 31, which subsequently led to the reinstatement of the redetermination process.
The class-action suit was filed in the U.S. District Court of Jacksonville against Jason Weida, the AHCA secretary, and Shevaun Harris, the DCF secretary. The plaintiffs listed are three individuals: Chianne D., a 25-year-old resident from Jacksonville; her two-year-old daughter, C.D., who has cystic fibrosis, and; A.V., a one-year-old resident of Miami Dade County. The Florida Health Justice Project and the National Health Law Program filed the lawsuit on their behalf; their full names were not disclosed in the document.
The lawsuit argues notices sent to Medicaid recipients—stating their coverage termination—”routinely fail to include…the legal or factual basis for the agency’s decision.” This document often showcases a set of ‘reason codes,’ offering minute or no explanation for the agency’s decision.
Both Chianne D. and her daughter were previously enrolled in Medicaid and received a 12-page notice from DCF in April. The document stated their coverage would end on May 31, reportedly due to receiving assistance from another program. This prompted Chianne D. to contact the DCF, only to be rebuffed by a representative citing time restrictions.
The plaintiffs’ coverage ended on May 31 as planned, forcing Chianne D.’s daughter to forego her essential medical treatment for several weeks, including prescription medications. Currently, the child has been enrolled in CHIP, but her mother remains without any coverage.
Plaintiff A.V. and her mother encountered a similar experience. The former was due to receive a vaccination on June 6. However, the mother received a call beforehand from A.V.’s pediatrician informing her that her daughter no longer had insurance coverage due to an 8-page notice from DCF. The notice stated the termination of coverage from May 31 and provided a confusing reason that she did not understand. As a result, A.V. remains uninsured.
The AHCA’s communications director, Bailey Smith, labeled the lawsuit as ‘baseless.’ He further added that while they could not comment on pending litigation, their “letters to recipients are legally sufficient. In fact, CMS approved the Department’s redetermination plan based on their regulations.”
According to KFF, more than 5.2 million people have been disenrolled from Medicaid coverage so far, with 408,000 in Florida alone. To read more, visit this article.