Florida to extend Medicaid coverage for new mothers to a full year postpartum [Miami Herald] – InsuranceNewsNet

For a decade, Florida lawmakers refused to extend eligibility for the public health insurance program, Medicaid, to all low-income adults, as mandated by the Affordable Care Act.

But this week Florida received approval from federal regulators to extend Medicaid benefits to a group of residents for whom state lawmakers had requested additional coverage: new mothers.

Florida will join California, Kentucky and Oregon as states newly approved to expand postpartum Medicaid coverage for eligible women from 60 days to 12 months — a policy change that will benefit approximately 126,000 women in those four states, including 50,000 women in Florida.

Illinois, Louisiana, Michigan, New Jersey, Caroline from the south, Tennessee and Virginia already extended postpartum Medicaid and Children’s Health Insurance coverage for a year.

Essential for new mothers, infants

The extension is key to ensuring maternal and child health, as most new mothers receiving Medicaid in Florida become uninsured once their 60-day coverage period ends, said Alison Yagernonprofit group executive director Florida Health Justice Projectwho took the initiative to lobby state legislators for coverage expansion.

“When parents are covered, they’re more likely to have child care,” said Yager, who added that expanding Medicaid coverage will also help ensure mothers have a chance of staying healthy between pregnancies.

“One year of postpartum coverage is not enough to ensure people who give birth stay healthy throughout their childbearing years,” she said. “Any obstetrician will tell you that we need medical coverage before pregnancy, during pregnancy and after pregnancy.”

Florida legislators have budgeted approximately $240 million for the extension of postpartum Medicaid coverage, although the state will only pay approximately $89 million of this amount and the rest will be covered by the federal government. The extension should come into force July, 1st.

Medicaid paid nearly 50% of all Florida births in 2020, according to the Florida Department of Healthand extending health insurance coverage to these mothers will help them access doctors, treat chronic conditions, and find mental health services during the postpartum period.

Cover to be withdrawn after one year

After a year, however, it won’t be easy for mothers to keep their Medicaid coverage. Florida. Pregnant women may qualify for coverage if they earn less than 196% of the federal poverty level, or approximately $26,500 one year for an individual.

After the pregnancy coverage period ends, the same mother cannot earn more than 30% of the federal poverty level, or approximately $7,000 one year for a family of three, to qualify for Medicaid in Florida.

Florida also has categorical exclusions for Medicaid coverage. Single adults without dependent children or with physical disabilities cannot qualify. Only adults who meet the income limits and who are also pregnant or have dependent children, or who are blind or disabled, or who are 65 and older can qualify.

Children whose parents respect the state income limits – between $31,000 and $46,000 for a family of three – also eligible for Medicaid coverage in Florida.

More than 5.2 million Floridians were enrolled in Medicaid as of April and about half of them are children, according to the state. Agency for Healthcare Administration, which administers the program. Medicaid enrollment increased steadily in Florida and elsewhere since the federal government declared a public health emergency due to the COVID-19 pandemic in March 2020.

Due to the public health emergency, the federal government has given states a small increase in their Medicaid payments. In return, states agreed not to delist people who obtained Medicaid coverage unless they left the state.

Millions of Floridians could lose health coverage

Once the public health emergency is over, possibly as early as October, Florida OH THAT will be responsible for restarting annual renewals for all in their Medicaid programs if they have been unable to verify eligibility – a huge administrative undertaking that could result in the loss of coverage for millions of Floridians, especially children .

Although many more Floridians have Medicaid coverage now than before the pandemic, Yager with the Florida Health Justice Project said it is important to remember that health insurance coverage does not necessarily equal access and care.

Many Floridians on Medicaid are experiencing long wait times to see a doctor or have received special medical services, and Yager said monitoring whether there are enough doctors and other care providers will be key. healthcare to serve the Medicaid population.

“Anyone can have Medicaid, but are they able to find a health care provider who is in their network in their area,” she said. “Are there enough mental health care providers in a particular area? This is something we’re going to want to keep in mind moving forward. »

© 2022 Miami Herald. Visit miamiherald.com. Distributed by Tribune Content Agency, LLC.

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