Several civil rights groups have recently filed a complaint against the Florida Department of Children and Families and the Florida Agency for Health Care Administration. They accuse the state of using administration practices that hinder continued Medicaid receipt by eligible beneficiaries, specifically those who are Latinos, immigrants, or Black. This action, according to the organizations, violates Title VI of the Civil Rights Act of 1964, which forbids those receiving federal funds from discriminating based on race or national origin.
This complaint comes as the United States starts to unravel the continuous enrollment provision initiated during the Covid-19 public health emergency. The provision, which prevented states from disenrolling Medicaid members in exchange for enhanced federal funding, ended on March 31, and states are now returning to the Medicaid redetermination process. This process involves verifying if enrollees are still eligible for coverage.
The complaint was raised with the Office of Civil Rights of the U.S. Department of Health and Human Services by various organizations. Among these are the Asian & Pacific Islander American Health Forum, Central Florida Jobs with Justice, Florida Health Justice Project, Florida Policy Institute, Hispanic Federation, Hispanic Services Council, Housing Education Alliance, Latino Leadership, The Leadership Conference on Civil & Human Rights, National Immigration Law Center, Protect Our Care, State Innovation Exchange Action, Equal Ground, MomsRising/MamásConPoder, and UnidosUS.
These groups outlined three state administrative practices they argue prevent underserved communities from renewing their Medicaid coverage. According to a Pew Research Center study, Florida Medicaid beneficiaries are “encouraged” to provide renewal information through the state’s Medicaid website, which cannot be accessed via smartphones. This disparity is significant, given that only 67% of Hispanic people have a desktop or laptop computer, compared to 80% of non-Hispanic Whites. About 25% of Latinos solely access the internet through their smartphone, compared to 12% of non-Hispanic Whites. Similar disparities exist for African Americans.
Furthermore, a recent UnidosUS study found substantial differences in wait times for Florida’s Medicaid call center depending on language. English-language callers wait 36 minutes on average to speak with a representative, while Spanish-language callers wait 2 hours and 22 minutes on average. More than half of Latino adults in Florida’s Medicaid program have limited English proficiency, as do 57% of Latino parents with incomes allowing their children to qualify, as per the American Community Survey data.
Lastly, the complaint claims that Florida complicates the inclusion of Latino and immigrant organizations in its approved community partners program. This program aids families in maintaining their Medicaid coverage through tasks like record lookups and form uploads. To receive certification for the program, however, staff members in these organizations must complete some English-only courses, posing a challenge for community health workers and navigators supporting Latino and immigrant communities with limited English proficiency.
The civil rights organizations stated that Florida could readily address these issues considering the state has a $20 billion budget surplus — nearly $3 billion was recently allocated for tax cuts. They suggested only a small fraction of the remaining budget would be needed to hire a contractor capable of making the Medicaid website accessible to smartphones, to employ enough call center staff for helping parents in any language, and to create translated training videos.
The Florida Agency for Health Care Administration has already dismissed the complaint as baseless. Its communications director, Bailey Smith, declared that while pending litigation prevents the state from commenting, the state’s letters to recipients are legally sufficient. Smith stressed that CMS approved the Department’s redetermination plan based on their regulations. Furthermore, the eligibility determination process involves several steps, and the final letter is only one of multiple communications from the Department.
The aforementioned complaint follows a preceding lawsuit filed against the Florida Agency for Health Care Administration and the Florida Department of Children and Families. The lawsuit claims that “tens of thousands of Floridians” are being removed from Medicaid coverage without receiving “adequate individualized written notice.” According to the KFF, more than 6.4 million individuals, which includes about 431,000 Floridians, have so far been disenrolled from Medicaid during the redetermination process.