$98 million Medicaid cut will harm vulnerable Floridians | Opinion

Anne Swerlick
Your Turn
Anne Swerlick

Gov. Rick Scott’s office recently pushed back on public criticism directed to a $98 million Medicaid cut scheduled to be implemented on July 1. They state the cut is “about paperwork, not patients.” This is flat out fiction.

The benefit on the chopping block is called retroactive Medicaid eligibility — RME. This technical “insurance-speak” term masks its overwhelming value for thousands of Florida families and their loved ones facing unexpected, dire illnesses or severe disabilities, or those needing nursing home care. 

Now, if someone is approved for Medicaid, the law requires that coverage go back three months prior to the month of application if the person would otherwise meet eligibility requirements such as income and asset limits.

Congress adopted the 90-day requirement in 1972 to protect people who are eligible for Medicaid but do not apply for help until after they have received care.

The same reasons exist today. Medical crises often give rise to a time lag between a loved one getting imminently needed care and the family applying for coverage. 

Florida’s Medicaid eligibility policies are complex and opaque. There are over 40 categories of eligibility and hundreds of pages of related policies. Many people do not know they are currently Medicaid eligible or the circumstances when they would become eligible.

The truth is that most uninsured healthy people will not qualify until they are hit by a life-threatening illness or disability. This is particularly the case in states — like Florida — that have not expanded their Medicaid programs to cover low-income adults. Taking away RME means that more uninsured Floridians will suffer delays in accessing care for life-threatening conditions such as cancer, heart disease or diabetes, and shoulder more medical debt and bankruptcies.

Another negative consequence: The cut in retroactive coverage will lead to greater uncompensated care burdens for Florida hospitals, which already total up to $2.4 billion annually. Eliminating RME coverage just increases this deficit. The Florida Chamber of Commerce estimates that insured Floridians pay about an extra $2,000 for every hospital stay to cover the cost of the uninsured.

If this cut is just about paperwork, and RME has no value, then why did the Legislature rightfully act to keep this benefit for pregnant women and children? The governor's nothing-to-see-here campaign is a thinly disguised effort to deflect from the fact that this cut disproportionately hurts elderly and disabled Floridians when they are in the most desperate of situations. 

Scott, however, has the power to stop this train. Before this cut can be implemented, Florida must get permission from the federal government. That's because RME is required under federal law. Notably, Kentucky, a state that has gone down this path, is getting sued. Scott could wisely decide to at least delay seeking permission to cut RME until the issue is settled in the courts.

Not only would this potentially save Florida taxpayer dollars diverted for likely litigation costs to defend this cut, it would bring peace of mind to the most vulnerable Floridians.

Anne Swerlick is a health policy analyst & attorney at the Florida Policy Institute.