Florida wrongly kicked postpartum women and their newborns out of Medicaid

A mother holding a newborn. Credit: Getty Images

JACKSONVILLE — The trial in the federal class action filed by Medicaid patients against the Florida agencies that handle the subsidized health care program resumed on Monday, with an employee acknowledging the state had mistakenly ended coverage for postpartum women and newborn children.

The named plaintiffs, mothers and their children, argue that the Florida Agency for Health Care Administration and the Florida Department of Children violated their constitutional right to due process because the notices they received about their Medicaid coverage denials lacked any explanation for the loss of benefits.

This is a high-stakes case because if the plaintiffs succeed, all the people the state kicked out of Medicaid without proper notice could have their coverage restored. Since the end of continued Medicaid coverage under the COVID-19 public health emergency in early 2023, Florida removed 1.9 million people from the program, according to KFF’s tracker of the situation .

While some of the named plaintiffs have already been reinstated with back benefits, it’s unclear whether that would happen for everyone the class action covers.

A glitch in the system

Some of the plaintiffs shouldn’t have lost coverage, even if their income exceeded the cap, because the state must provide health care to women and children for up to a year following birth. Attorneys for AHCA and DCF are not contesting that the state made that mistake and that it had miscalculated applicants’ income and family size to determine eligibility.

William Roberts, a second-tier government operations consultant for DCF, testified that the agency had been aware since April 2023 of a glitch in its system that stopped postpartum coverage after two months, instead of the 12 months required by law. Evidence in the case showed that the same problem happened to plaintiffs in October and possibly March of this year.

The plaintiffs argue that they couldn’t properly fight those decisions through the agencies because they didn’t have access to the information used to deny benefits. The notices, call center representatives, and the online portal lacked that information, attorneys from the Florida Health Justice Project and National Health Law Program argued in court on Monday.

DCF call center agents provided wrong information

Evidence during Monday’s hearing featured recordings of several calls 25-year-old Chianne D. — whose three-year-old has cystic fibrosis — made to the DCF call center to ask why she and her daughter no longer had full coverage. The plaintiff is going by her first name to protect the identity of her child.

“I was angry. I was confused,” Chianne testified about how she felt when she made the calls.

The calls ranged from 11 minutes to nearly half an hour and grew increasingly tense. Call center employees mistakenly said Chianne and her daughter still had full Medicaid coverage and told her she would get a call back from more knowledgeable agents. Chianne never got the promised calls.

“I’ve been getting shoddy information that has been borderline illegal,” Chianne said to a call center employee during a heated 28-minute phone call. “I’m not going to sit on the phone and go through every single thing … that’s not my job,” the call center employee replied.

The mother didn’t inquire about her own loss of coverage, to which she was still eligible because she had given birth recently.

“I don’t understand what’s going on,” Chianne told another call center agent as she explained that the medication to treat her daughter’s condition costs more than $300,000 per year.

Roberts acknowledged the call center agents provided Chianne with “conflicting information,” after testifying that Medicaid recipients could rely on information from the call center.

“How is someone supposed to know which of two call center operators are giving them the right information?” National Health Law Program attorney Sarah Grusin asked Roberts.

“I don’t know,” he replied. He has worked with DCF handling Medicaid cases for 25 years.