Florida's Medicaid call center's wait times are hindering health care access, study warns

MIAMI — The Medicaid call center in Florida is experiencing long wait times and high rates of disconnection that could be preventing qualifying families from renewing or accessing Medicaid coverage, according to a report by UnidosUS, a national Hispanic civil rights and advocacy organization.

Around 1 million people, 17% of Floridians enrolled, have lost coverage since April, which is when the state started redetermining Medicaid eligibility for the first time since 2020. During the pandemic, Congress had put in place provisions barring states from ending Medicaid coverage regardless of whether or not people qualified, but that expired last year.

Florida's drop in Medicaid enrollment is the second largest in the country after Texas’, according to the UnidosUS study.

8 in 10 calls automatically disconnected

Issues with the call center are at the heart of the problem, said UnidosUS’ Florida political director, Jared Nordlund. One way the state decides whether people are no longer eligible for Medicaid, he said, is if they don’t respond to correspondence mailed to them. Many times, people have questions about the mailer they've received and aren't sure what they need to do to avoid being dropped. Yet, when they try to reach out to the state's Medicaid call center, it’s nearly impossible to get through to a real person.

The report found that 8 in 10 calls to Florida's Medicaid call center were automatically disconnected from the phone system. When people managed to get through, there were long delays to reach live receptionists.

“For Florida families who rely on hourly wages to make ends meet, spending hours just to connect is a costly proposition,” Nordlund said. “We have to meet people where they are, and right now they are frustrated and scared. The state has the money to fix the call center problem; they’re just choosing to ignore it.”

For English speakers, the average wait time was 66 minutes, almost double what it was in July. And for those who speak Spanish, the wait time was 47 minutes, which went down from the hour and 35 minutes people were waiting in July.

The Florida Department of Children and Families, which administers the program, didn't immediately respond to a request for comment.

Medicaid, which provides health insurance for lower-income people, is mostly administered by states, though the majority of the funding comes from the federal government.

According to the study, the long wait times could be contributing to loss in Medicaid coverage.

A significant proportion of the Medicaid population "needs access to real, live people who can help them with the redetermination process, which is why the continued failures of the state’s call center only compound problems instead of solving them," Nordlund said. "In addition to the digital divide that keeps many from being able to access the process online, there is often a linguistic barrier or a need for guidance with the forms.”

Two consumer advocacy groups sued in a Florida federal court last summer seeking to stop the state from terminating residents’ coverage. The Florida Health Justice Project and the National Health Law Program filed the suit on behalf of three residents arguing that the notices are confusing and don’t explain well why a person is being dropped.

As many Floridians' Medicaid coverage has been terminated, the number of people enrolled in the Affordable Care Act has spiked. Florida leads the country in ACA enrollment, with 4.2 million residents signing up during the recent open enrollment period.

The decrease in Medicaid coverage isn't the only reason for the rise in ACA sign-ups, though. Enhanced subsidies offered during the pandemic and extended through 2025 as part of the Inflation Reduction Act have made it less costly to sign up for health plans.

The UnidosUS report is a follow-up to one the organization released in August, which found Spanish speakers had to wait nearly four times longer than English-language callers.

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This article was originally published on NBCNews.com