South Florida Sun Sentinel. April 13, 2024.
Editorial: Florida’s Medicaid downsizing is a moral failure
The headline demanded your attention for the timing, if nothing else: “Some of Florida’s sickest kids are losing Medicaid coverage on Easter Sunday.”
Advocates around the state worried that the message didn’t reach the parents of some of those kids, or the medically fragile adults who also depend on Medicaid coverage.
Despite news stories, warnings from nonprofit groups and messages from state officials, many Florida residents whose coverage and that of their children was being dropped said they had no warning until the ax fell.
While the state claims that 93% of those families whose kids were being dropped had been contacted, that doesn’t square with statistics posted during earlier phases of the state’s downsizing of its COVID-swollen Medicaid ranks.
It also doesn’t explain the large numbers of people who were previously shoved off the Medicaid rolls despite the state’s failure to prove them ineligible.
And it casts shade on the state’s decision to move as quickly as possible to shed people from the Medicaid system, along with its status as one of only two states that refused to take advantage of assistance offered by the U.S. Department of Health and Human Services.
The great unwinding
The disenrollments stem from a reset of a COVID-era policy that allowed current Medicaid recipients to keep their coverage — even if they no longer qualified — through the end of the pandemic emergency.
Last year, federal officials told states to start moving people into other programs if they were no longer eligible for Medicaid, with guidance to “unwind” participation in the Medicaid program gradually.
Florida moved as quickly as possible. According to data compiled by the Florida Health Justice Project, 3.7 million Floridians had their Medicaid eligibility reviewed by December 2023.
Of those, more than 2 million kept their eligibility, including nearly 900,000 whom the state deemed eligible without contacting the recipient.
That sounds like a lot, but other states did a much better job of keeping people in the Medicaid program using their existing records.
The far more disturbing breakdown is the high percentage of people who had already lost coverage at that point — and may never have known it.
Of the 1.2 million kicked off Medicaid rolls through 2023, about 72% were dropped for “procedural” reasons that said nothing about their current ineligibility.
Most often, it was due to a failure to respond.
That doesn’t speak well for the state’s claim that it is reaching people and letting them know about options before they are dropped.
And that’s why advocates like the Health Justice Project, the Florida Policy Institute, the Kaiser Family Foundation and the Center for Budget and Policy Priorities have been sounding the alarm about Florida’s “unwinding” process since early last year.
They had good reason to be nervous about the last group of state disenrollments, which included the sickest and most frail among Florida’s Medicaid enrollees.
These are people who — if they lose eligibility under Medicaid — should be most qualified to move to another state-backed entitlement program such as Medikids, which offers very low-cost insurance for children ages 1-4, or Children’s Medical Services (CMS) which takes care of special needs kids.
Nowhere to turn
But those programs aren’t seeing as much of a surge in demand as they expected — and our reporting backs up health-access advocates who say the state has little information for families who need to transition to another program.
That puts parents and sick adults in a terrible bind: Many might be eligible to stay on Medicaid. Others can appeal a decision to drop them from Medicaid or move to another program. But they don’t know what to do or how to do it.
Attempts to reach out to state officials often result in long hold times or erroneous responses, the Health Justice Project and other advocates say.
There’s an easy answer to this growing desperation: Florida should expand Medicaid eligibility to cover more hard-working and low-income residents.
The state is one of only 10 that haven’t taken advantage of Medicaid expansion, which reaches people who make too little to participate in “Obamacare” marketplaces but too much to remain on Medicaid.
We have a hard time understanding why Florida didn’t expand Medicaid a long time ago — or why it has failed to take advantage of federal offers of additional time and help for those being cast off Medicaid rolls during the “unwinding” process.
State officials keep insisting they’re doing the best they can, but that assertion is proven false every time new statistics are released, or stories appear about parents of very sick children, or disabled adults who have lost the care that could be keeping them alive.
Florida can do better. It should do better. It’s a moral failure that it has not.
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Tampa Bay Times. April 10, 2024.
Editorial: SAT and ACT test scores matter. Schools should use them
The test scores are a solid indicator of how well an applicant will handle college or university.
Even their biggest proponents acknowledge that standardized tests such as the SAT and ACT are imperfect tools for university admission. Expensive test prep can give affluent students a significant leg up. Critics have attacked some questions as culturally biased.
But in recent months, a handful of well-regarded universities have decided to once again require the tests after a COVID-induced suspension led as many as 2,000 schools to make them optional. Universities such as Dartmouth, MIT, Georgetown and Yale say they now believe that assessment testing is key to something crucial — helping schools identify promising students who might otherwise fly under their admissions radar.
We’re talking about the low-income student whose SAT score is 400 points higher than his school’s average. Or the student whose GPA suffered from family issues, but who still managed to ace the test.
“With a test-optional policy ... we were unintentionally overlooking applicants from less-resourced backgrounds who could thrive here,’’ wrote Dartmouth President Sian Leah Beilock, a cognitive scientist who said that will change starting next year.
Mercifully, optional testing was never an issue in Florida because state schools never dropped the requirement. In fact, Florida has actually added a testing option since COVID — the conservative and Christian-backed Classic Learning Test, which focuses on the classical Western and Christian canon.
State leaders were right to be stubborn (at least about the ACT and SAT). When combined with other traditional tools such as grade point average, student essays and teacher recommendations, standardized tests allow for a fairer, more holistic evaluation of applicants.
We’re not trying to criticize the many schools that went to optional testing after COVID began ripping through the nation four years ago. Most testing centers had to be closed because of social distancing. And given the already existing concerns about standardized tests, the path of least resistance clearly was to leave the testing decision up to students, who were told they could submit a score if they thought it would help but would not be penalized if they didn’t.
Dartmouth’s experience illustrates why that probably wasn’t the best move. When Beilock became president last year at the New Hampshire university, an Ivy League school that typically accepts about 6% of freshmen applicants, she asked for an internal study on standardized testing. She told The New York Times there were two main findings, one surprising and one not.
The not surprising: that test scores were a better predictor than grades, essays and teacher recommendations of academic success at Dartmouth. But researchers said their analysis of test score data also showed something unexpected — that lower-income students were withholding test scores that would have helped them get in.
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Miami Herald. April 13, 2024.
Editorial: Optimistic Democrats vow to retake Florida. GOP numbers offer a harsh reality check
Since Donald Trump carried Florida in 2016 and then, again, by a larger margin in 2020, the Democratic Party has been supposedly staging a comeback in the Sunshine State.
So far, Democrats have little to show for it. The numbers have been going in the opposite direction: The Republican Party is becoming more popular among Floridians — if voter registration tallies are an indication.
This week, registered Republicans outpaced Democrats by 892,000 voters, up from an edge of 851,000 at the end of February. The GOP’s party chair told Politico he expects to have a one million-plus advantage by the November elections.
There is a caveat to these numbers, Democratic Party spokeswoman Eden Giagnorio told the Herald Editorial Board. Voter registration numbers don’t take into account “inactive” voters who are still eligible to cast ballots, or independent voters.
Thanks to Florida’s new election laws, thousands of voters have been deemed inactive with Democrats being “disproportionately impacted,” she said. When you factor them in, the Republican advantage is closer to 509,000 voters based on 2023 data, according to Giagnorio.
“Republicans are lying about their advantage... they are not telling the whole story,” she said.
Regardless, the numbers don’t look good for Democrats. Until just three years ago, they led the state in voter registrations. Not only did the GOP catch up with them, it surpassed them by stunning margins.
That’s why there’s a “we’ll believe it when we see it” feel to the Florida Democratic Party’s “Take Back Florida Coordinated Campaign” launching this weekend.
When Republicans won Miami-Dade County for the first time in two decades in 2022, that was not just a reflection of Gov. Ron DeSantis’ popularity — he won reelection by nearly 20 points — but also the long game the GOP has played nurturing support among Hispanic voters, and not just Cuban-Americans who have always leaned conservative.
A constant complaint from Democrats is how the party failed to engage those voters on a regular basis. It’s what Miami-based Democratic pollster Fernand Amandi described as “demolition by neglect.”
“I have seen a virtual abandonment of the field in South Florida,” Amandi told the Herald Editorial Board.
Meanwhile, the Republican Party has treated Florida as its “base state,” Amandi said, attracting conservative voters from other parts of the country. Florida has become a laboratory for GOP policies, from DeSantis’ war on “woke” to his administration flying migrants from Texas to Martha’s Vineyard.
Hoping that voters would shun the GOP’s extreme laws — such as the one known as “Don’t say gay” or the six-week abortion ban that goes into effect on May 1 — has not paid off so far. More than calling out Republicans’ excesses and Trump’s anti-democratic tendencies, Florida Democrats must show voters their vision for the state.
To be fair, since 2022, there have been some important Democratic victories under new party chair and former Agriculture Commissioner Nikki Fried. Democrats flipped a House seat in a January special election in Central Florida and the mayor’s office in Jacksonville, the state’s largest city, last year.
In the 2024 elections, Amendment 4 to protect abortion rights — along with another ballot measure to legalize recreational marijuana — might be Democrats’ best shot at boosting voter turnout and attracting much-needed money from wealthy donors. But that’s not a given. Voters upheld abortion rights in every state where the issue was on the ballot, but several Democrats on those same ballots lost, a Politico analysis found.
It all goes back to investing in the state long before ballots are cast. There are signs that the Democratic Party is taking that seriously. This weekend, they will kick off their “Take Back Florida ” initiative with eight events across the state, including in Miami-Dade, to register Democrats and re-enroll them to vote by mail.
With seven months before Election Day, will that be enough? Only if Democrats don’t live up to their reputation of getting in their own way in Florida.
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