Decision affirms constitutional protections against confusing termination notices as states prepare to implement new Medicaid work requirements
JACKSONVILLE, FLORIDA — The National Health Law Program (NHeLP) and Florida Health Justice Project (FHJP) secured a major appellate victory in Chianne D. v. Weida when the U.S. Court of Appeals for the Eleventh Circuit affirmed a ruling that Florida’s Medicaid termination notice system violated the constitutional rights of enrollees. The 3-0 decision, written by Judge Barbara Lagoa upholds a permanent injunction requiring Florida to clearly explain whose coverage is ending and why, protecting hundreds of thousands of Floridians and reinforcing safeguards against wrongful loss of health care.
The lawsuit challenged Florida’s confusing and incomplete notices. Families received contradictory information about whose coverage would end and lacked the individualized information needed to identify errors and challenge the state’s decisions. The record documented widespread wrongful terminations affecting new moms, a weeks-old infant, and families with children with disabilities. These families faced a maze of complex rules and regulations with no help from the state Medicaid agency, problems that the appellate judges described at oral argument as “systemic,” “pretty bad,” an “abject failure,” even asking Florida “What is the whole point of hiding this information?”
“For families in Florida, losing Medicaid is scary and stressful. It can mean missing a child’s checkup, going without medication, or delaying care during pregnancy or after giving birth,” said Sarah Grusin, Senior Attorney at the National Health Law Program. “The families who brought this case faced notices they could not decipher and could not get reliable answers about their coverage despite exhausting efforts to get an explanation from the agency. Their persistence has secured critical protections for hundreds of thousands of Floridians. This victory helps ensure families have the information they need to catch mistakes and defend their access to health care.”
The appeals court rejected Florida’s argument that call centers, online resources, and other assistance adequately supplemented its deficient notices. It also upheld relief for the class, including requirements that notices provide household size, countable income, and sufficient information about the eligibility categories and income limits the state applied.
“Due process requires more than a letter announcing that someone no longer qualifies for Medicaid,” said Lynn Hearn, Legal Director at Florida Health Justice Project. “People must be able to understand the state’s decision and the facts behind it so they can decide whether to challenge it, especially because mistakes are so frequent in Florida’s Medicaid program. Florida cannot leave families guessing, send them searching for answers through an unreliable system, and offer an adequate explanation only after they request a hearing. The court affirmed that these protections are a constitutional obligation.”
The decision comes as states prepare to implement Medicaid work requirements and other eligibility changes under the so-called “One Big Beautiful Bill Act” (OBBBA), bringing even more urgency to the design of notices that explain coverage decisions. Florida has already begun issuing notices to immigrant enrollees noting coverage terminations.
“As states prepare for a new wave of Medicaid paperwork and notices under OBBBA, they should heed this decision,” said Katherine DeBriere, Senior Attorney at the National Health Law Program. “People need enough information to understand why the state proposes to end their coverage and to challenge mistakes. States must build those protections into their systems now. Confusing notices and inaccessible explanations put people’s health care at risk.”
NHeLP and FHJP will continue working to enforce these protections and hold Florida accountable for providing constitutionally adequate notice before terminating coverage.
