This blog is part of our Working Better Together series and was written by Dr. Maira Martelo, Director of Engagement and Storytelling at Florida Health Justice Project. This blog series is intended to provide our Health Law Partnerships and advocacy partners with a platform to highlight successes, challenges, and innovative approaches to furthering health access and health equity in the states where they work.
The “Medicaid Experiences” project referenced in this blog series is a collaborative endeavor of the National Health Law Program and eight state-based legal aid organizations. The purpose is to better understand the direct experience of individuals as enrollees and applicants for Medicaid and advocate for improvements.
Many mothers in Florida face insurmountable challenges that go beyond the regular obstacles of motherhood. In addition to having to juggle the traditional responsibilities of taking care of their families, many mothers in the state are being wrongfully denied Medicaid coverage, for them and their babies, before and after delivery.
Despite the fact that in May 2022, the Centers for Medicare and Medicaid Services approved Florida’s extension of Medicaid postpartum coverage from 60 days to 12 months, numerous women in Florida have lost their coverage when they shouldn’t have. During a recent federal trial, Florida Medicaid officials admitted that a system-wide error did not correctly apply pregnancy and post-partum coverage to eligible individuals. Officials have not said how many people were affected or what steps they took to notify people who may have been affected by the error.
Mandi is one of those women; she and her newborn both lost coverage shortly after delivery. “The scariest part was when I learned that Vernita, my newborn, had been dropped from Medicaid and couldn’t be enrolled in KidCare until she turned one. She is not covered during the period of her life when she has the most doctor’s appointments. I paid for her 4-month checkup out-of-pocket and was able to do her 6-month visit at our local community center,” Mandi stated. KidCare is Florida’s CHIP program which offers coverage for children whose family income is over the limit for Medicaid, but eligibility begins at age one.
According to recent research conducted by the Commonwealth Fund, a nonpartisan foundation, Florida ranks 48 out of 50 states and Washington D.C. for health coverage, access, and affordability for women. It is estimated that at least 14 percent of women between the ages of 18 and 64 in Florida don’t have healthcare coverage.
As poverty rates continue rising nationally, many women have had no choice but to stop getting all but emergency healthcare. In Florida, at least 29% of women between the ages 18-44 say they don’t have a primary care provider. When care is needed, most people in this situation turn to emergency rooms or urgent care centers.
Navigating the Medicaid unwind has proven to be very challenging. We’ve heard from numerous clients and individuals who’ve shared their stories that they spent days calling DCF and other government agencies to check on the enrollment status for themselves and their kids.
Lily, one of our clients, spent nearly three weeks calling DCF trying to get her Medicaid coverage reinstated while she was seven months pregnant. DCF wrongly believed that she was over-income for pregnancy Medicaid.
Despite filing an appeal with the support of FHJP, Lily had no coverage when she was hospitalized for early labor. She couldn’t fill her prescription or attend critical appointments with a high-risk obstetrician. It took 22 days of constant advocacy to get her coverage reinstated.
Lindsey, another client of FHJP, had a similar experience, and was forced to go to the DCF office because getting through to the call center was impossible. “I went to talk to them face to face because I can’t ever get DCF on the phone. When I was pregnant, I was on the phone for 4 hours, then transferred and then on hold for another 3 hours; then the call was dropped,” she stated.
No new parent should have to deal with the scare and the very real dangers of losing coverage for themselves or their newborn! It took the help of advocates to step in and get Lindsey and her baby back on Medicaid, though they remained eligible throughout.
Thankfully, with the help of FHJP Lily and Lindsey were able to restore coverage for themselves and the newborns, and are now able to access medical care. FHJP will continue to assist families affected by the state’s error, and to tell the stories of these losses, for as long as necessary to ensure that all eligible individuals receive the coverage to which they are entitled.
