Medicaid enrollment surge means major workload for state

TALLAHASSEE, Fla. – Florida has seen a spike in Medicaid enrollment since the COVID-19 pandemic began, and the agency responsible for enrolling and disenrolling people in the health-care program is swamped.

Mark Mahoney, a 16-year veteran at the Department of Children and Families and director of revenue management, told state economists last week that processing Medicaid applications during the COVID-19 pandemic, as well as applications for other social service programs, has been an enormous undertaking.

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And it won’t get easier any time soon as the state begins to consider ways to review the financial documents of an untold number of Medicaid beneficiaries to ensure they remain eligible for coverage if and when a public-health emergency declaration expires.

The department generally reviews Medicaid beneficiaries’ eligibility each year. But those reviews have been put on hold since March, when the federal public-health emergency took effect. The federal Centers for Medicare & Medicaid Services has indicated it will issue guidance in the coming weeks about how state Medicaid officials should proceed with the annual reviews.

“The application work that is going to have to happen with all the redeterminations, with all the determinations, and everything going forward, that’s a factor that has to be discussed more and analyzed at a much deeper level,” Mahoney told members of a state panel known as the Social Services Estimating Conference Committee, when asked about the department’s workload.

Florida’s Medicaid program, which provides services to poor, elderly and disabled beneficiaries, had 4.417 million people enrolled as of Oct. 30, according to Agency for Health Care Administration data. In a report posted online Monday, state economists said enrollment would be about 4.42 million at the June 30 end of the fiscal year, a 16.5 percent increase from the prior fiscal year.

AHCA Secretary Shevaun Harris told The News Service of Florida she does not know how many Medicaid redeterminations were put on hold due to the public health emergency. She said the Department of Children and Families was reviewing the data.

The Department of Children and Families did not return requests for comment. AHCA runs much of the Medicaid program, but the Department of Children and Families handles issues such as eligibility determinations.

Harris confirmed, however, that the state will “need to go back and assess all people whose eligibility would have ended between March and when the public health emergency ends and figure out if they still qualify. And if they don’t, we need to terminate their eligibility.”

Mahoney told members of the Social Services Estimating Conference that following the coronavirus-caused economic shutdown in the spring that the Department of Children and Families -- which closed storefronts where people could apply for benefits -- focused its efforts on increasing staff at call centers.

“They grabbed folks from all over the department and repurposed them,” Mahoney said, adding “the workload was huge.”

Mahoney compared the surge to what happened at the Department of Economic Opportunity, which oversees the state’s unemployment program, but added that “for DCF, it was massive, and it still is.”

The Department of Economic Opportunity made headlines after it was unable to handle a crush of unemployment applications stemming from the coronavirus, and Gov. Ron DeSantis redirected an additional 2,000 state employees to assist in the call volume.

While DeSantis has pushed to reopen the state and restart the economy, Mahoney said the Department of Children and Families still is getting a lot of calls from residents looking to apply for Medicaid. They also are applying for the Temporary Assistance to Needy Families program, which provides financial assistance to unemployed families, and a federal food-assistance program.

Mahoney predicted that the agency would continue to have a higher-than-normal call volume for Medicaid applications and pointed to a stalemate in Congress over a new coronavirus relief package.

“Everyone’s wondering when the next round of stimulus is,” he said adding, “So as long as there is this unknown out there, folks who aren’t on those programs are going to apply if they are currently unemployed.”


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