Gov. Ron DeSantis last week joined 24 other Republican governors in asking President Joe Biden to end a COVID-19 emergency declaration that has helped lead to a surge in enrollment in Florida’s Medicaid program.
The governors sent a letter that urged Biden to allow a federal “public health emergency” to expire in April. The emergency declaration was initially issued in 2020 and has been repeatedly extended. The letter said it has been extended until at least Jan. 11, though states believe it will be extended to April because they have not received notification that it will end.
“We ask that you allow the PHE (public health emergency) to expire in April and provide states with much needed certainty well in advance of its expiration,” the letter said.
State and federal governments jointly fund Medicaid. During the emergency, the federal government increased its share of the tab by 6.2 percentage points through a formula known as the Federal Medical Assistance Percentage.
But at the same time, state Medicaid programs have not been able to drop beneficiaries who might otherwise be ineligible for coverage. That has helped swell Medicaid rolls in Florida and other states.
For example, Florida had about 3.76 million people enrolled in Medicaid in March 2020, when the pandemic slammed into the state. In November 2022, it had nearly 5.58 million people enrolled, according to data posted on the state Agency for Health Care Administration website.
“The PHE is negatively affecting states, primarily by artificially growing our population covered under Medicaid … regardless of whether individuals continue to be eligible under the program,” the governors’ letter said. “While the enhanced federal match provides some assistance to blunt the increasing costs due to higher enrollment numbers in our Medicaid programs, states are required to increase our non-federal match to adequately cover all enrollees and cannot disenroll members from the program unless they do so voluntarily.”
In an October decision to extend the public health emergency to January, the U.S. Department of Health and Human Services pointed to the “continued consequences” of the COVID-19 pandemic.
Medicaid, which serves low-income Floridians, seniors and people with disabilities, is a massive part of each year’s state budget. Lawmakers in March approved a 2022-2023 budget that included $38.6 billion for the Agency for Health Care Administration, which operates most of the program.
Other governors signing the letter were from Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Massachusetts, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia and Wyoming.