By John Haughey
The Center Square
November 25, 2020
Florida’s Medicaid enrollment has increased by 16% since March and will continue to swell through next year, topping out at nearly 4.6 million state residents relying on the federally subsidized health care program by 2022, according to projections by state economists.
In analyses published Monday – the Medicaid Caseload Summary and the Medicaid Caseload Forecast Comparison – after a Nov. 19 Social Services Estimating Conference (SEC), economists forecast 4.44 million Floridians will enroll in Medicaid during fiscal year 2021, which began July 1 and ends June 30.
That would constitute a 16.5% increase over the state’s fiscal 2020 Medicaid enrollment of 3.8 million people, about 80,000 more than what economists forecast during July’s quarterly SEC and at least 800,000 more than what lawmakers budgeted for when they adopted the state’s $29.7 billion Medicaid plan for fiscal 2021.
Economists forecast Florida Medicaid enrollment will increase by 3.3% – to 4.59 million people – in fiscal year 2022, about 220,000 more than economists previously projected.
Beginning in fiscal year 2023, the analyses project the state’s Medicaid enrollment will decline by 2.3%, and then 1.9%, 1.8% and 1.8% in succeeding years to stand at about 4.24 million people in 2026, shedding nearly 350,000 people from the projected 4.59 million peak in fiscal 2022.
Economists and legislative analysts, who meet in various conferences throughout the year, such as the Revenue Estimating Conference (REC), will convene again in December to project how increased Medicaid enrollment will drive overall costs.
The estimates will guide lawmakers when they convene for committee meetings in January before the 60-day legislative session that begins March 3.
Tom Wallace, assistant deputy secretary of the Agency for Health Care Administration (AHCA), which manages Florida’s Medicaid program, said the pandemic induced 16.5% enrollment increase ranks “within the top eight of all the states.”
Wallace said the AHCA’s Medically Needy program, which helps Floridians who suffer acute illnesses or accidents but don’t qualify for Medicaid, is overwhelmed.
The program, which assists about 30,000 Floridians annually, is “drastically increasing, in some months, over 10,000” new people, Wallace said.
The good news, he said, is President Donald Trump’s administration has extended the federal COVID-19 public health emergency from Dec. 31 to March 31, meaning states will continue to receive assistance from the federal Centers for Medicare & Medicaid Services in paying for pandemic induced Medicaid enrollment increases.
Accepting that assistance, however, precludes Florida from removing anyone enrolled in Medicaid on March 18 or who has enrolled since because of the pandemic, and from making enrollment more restrictive than it was in January.
Office of Economic and Demographic Research (OEDR) coordinator Amy Baker acknowledged she was “surprised” at the projected Medicaid spikes.
“The (enrollment) increase was virtually – except for three or four (eligibility) categories – everywhere,” she said. “What we saw in the data was more complex than what I was expecting it to be.”
Economists used an economic forecasting model based on studies of post-pandemic economic recoveries to project it could take 12-15 months to claw back to pre-pandemic employment and revenue-generation levels.
The pandemic’s economic impact is particularly acute on Florida’s tourist economy, with many newly enrolled Medicaid recipients among those formerly insured by employers in the industry. Several tourist and hospitality industry groups forecast it will take two years to recover from the pandemic.
The total number of tourists declined 68% from in the second quarter and nearly 32% during the third quarter compared with the same quarters in 2019, according to numbers released last week by Visit Florida.