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FLORIDA MEDICAID BASICS

OVERVIEW

Medicaid provides essential health services to low-income people with disabilities, the elderly, children, families and pregnant women.

 

Medicaid programs are required to cover certain services including, but not limited to hospital, physician, nursing home and pregnancy-related services, as well as child health check-ups and treatment services for children and youth.[i]

The Florida Agency for Health Care Administration is the state agency with overall responsibility for administering the Florida Medicaid program. Medicaid eligibility is determined by the Florida Department of Children and Families.[i]

WHO IS ELIGIBLE?

HOW ITS FUNDED

Federal funds cover nearly 61 percent, or $15 billion, of the total $26.4 billion state Medicaid budget.

The state receives federal matching payments for the state’s total Medicaid costs. If the state has higher Medicaid costs in a year, it will receive increased federal funding to maintain the federal match.

The current funding structure gives Florida the flexibility to respond to unforeseen increases in health care costs due to changing demographics, new ways of delivering care, new medical technology and prescription drugs, public health emergences such as Zika and the opioid crisis and natural disasters.

WHO IT HELPS

Rural and Urban Communities

A recent study shows that uninsured rate declines and Medicaid coverage gains disproportionately benefited Floridians in rural areas and small towns. 

 

The share of uninsured children in these areas declined from 16 percent to 9 percent. At the same time, Florida children living in rural areas who were covered by Medicaid grew from 43 percent to 57 percent.

 

Compared to other states, Florida had the fourth highest share of children in small towns and rural areas covered by Medicaid. 

The uninsured rate for adults in rural areas and small towns also declined from 40 percent to 30 percent, while Medicaid coverage for adults increased (10 percent to 17 percent).[i] 

The charts below show Medicaid coverage gains for children by select major metro areas and rural Florida. 

[i] Section 409.902(1), Florida Statutes (2017). Accessed via: http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0409/Sections/0409.902.html

[i] Policy Basics: Introduction to Medicaid, Center on Budget and Policy Priorities, 2016, pp. 3-4. Accessed via:  https://www.cbpp.org/sites/default/files/atoms/files/policybasics-medicaid_0.pdf

[i] Wagnerman, Karina et al. 2017. Georgetown University Center for Children and Families, and the University of North Carolina Rural Health Research Program. Medicaid in Small Towns and Rural America: A Lifeline for Children, Families, and Communities. pp.14-15. https://ccf.georgetown.edu/wp-content/uploads/2017/06/Rural-health-final.pdf