In mid-Might, Mandi Rokx had a 3-month-old child and a letter from a Florida company warning that they each could be lower from Medicaid, the medical health insurance program for individuals with low incomes or disabilities.
Beneath a Florida legislation handed in 2021, Rokx was speculated to obtain 12 months of steady protection after giving start. However the letter from Florida’s Division of Youngsters and Households stated their protection would finish Might 31.
The reason: “You failed to finish or observe by means of together with your Medicaid renewal.”
Rokx stated she didn’t perceive why the state was chopping protection. She had supplied every part it requested for, she stated.
She apprehensive about what shedding Medicaid would imply for her daughter, Vernita. Initially after the protection ended, Rokx stated, she paid out-of-pocket for the toddler’s checkups. She then turned to a free well being truthful placed on as soon as a month by a neighborhood nonprofit close to her house in Melrose, Florida.
“I simply hope she doesn’t get sick,” she stated.
An unknown variety of moms in Florida have abruptly misplaced Medicaid protection after giving start, regardless of being eligible, in response to an ongoing federal lawsuit filed towards the state in August 2023. The difficulty is linked to the state’s pc eligibility system, run by Deloitte Consulting, in response to trial testimony from state and Deloitte staff. It’s but yet another instance of issues states and beneficiaries have encountered with Medicaid administration techniques operated by Deloitte, an enormous consulting agency.
As of July, Florida had awarded the worldwide agency contracts valued at greater than $100 million to modernize, function, and keep the state’s built-in eligibility system for Medicaid and different advantages.
Deloitte didn’t reply to requests for remark about its work in Florida.

In whole, 25 states have awarded Deloitte eligibility system contracts, making the corporate the dominant participant on this essential slice of presidency enterprise. These agreements, wherein Deloitte commits to design, develop, or function state-owned techniques, are value not less than $6 billion, in response to a KFF Well being Information evaluation of state contracts.
The KFF investigation discovered that errors in Deloitte-run eligibility techniques can price thousands and thousands and take years to repair whereas denying advantages like medical health insurance to eligible individuals.
In response to the investigation, Deloitte spokesperson Karen Walsh stated the agency’s shoppers — state governments — “perceive massive system implementations are difficult as a result of complexity of the applications they help and that every one IT techniques require ongoing upkeep, periodic enhancements and upgrades to software program and {hardware}, and database administration.”
Senate Democrat John Fetterman of Pennsylvania, which is one in all Deloitte’s state shoppers, sees it a lot otherwise. “Let’s name this what it’s: a racket,” he stated. “This isn’t an occasional glitch. It’s a sample of systemic failure. And the worst half? We’re paying them billions to do it.”
In July, Kimber Taylor of Jacksonville and Lily Mezquita of Orlando testified in a federal courtroom in Florida that state officers eliminated them from Medicaid despite the fact that their pregnancies made them eligible. The category-action lawsuit alleges that Florida didn’t adequately clarify to individuals with Medicaid the rationale for chopping their medical health insurance, or clarify to them that they might attraction the choice earlier than shedding protection.
Florida has denied the allegations in courtroom filings. However the trial revealed issues with the pc system the state makes use of to find out Medicaid eligibility and inform folks that they’re not eligible. Deloitte didn’t reply to questions concerning the trial, wherein a choose’s resolution is pending.
Though Deloitte isn’t a named defendant within the lawsuit, an worker was known as to testify concerning the agency’s position in working Florida’s eligibility system. Harikumar Kallumkal, a Deloitte managing director who’s accountable for Florida’s system, stated {that a} “defect” might have led to protection losses for brand spanking new moms.
William Roberts, a state employee who evaluations Medicaid eligibility choices, additionally testified that the company realized a couple of “glitch” that lower postpartum protection for eligible new moms in April 2023 — the identical month Florida launched a Medicaid eligibility evaluation course of often called “unwinding,” which all states undertook after pandemic-era protection protections led to March of that 12 months. Kallumkal testified that Deloitte mounted the issue by April or Might 2024.
And but Rokx’s protection was lower Might 31.
Through the unwinding, Florida disenrolled practically 2 million individuals, together with children, from Medicaid, in response to the Facilities for Medicare & Medicaid Providers.
Affected person advocates say flaws in Florida’s Deloitte-operated pc system prevented a number of the state’s most weak residents from getting care they have been entitled to obtain.
“Florida’s Medicaid officers knew from the beginning of the unwinding interval that their system was not dealing with being pregnant and postpartum Medicaid accurately, and proceeded full steam forward anyway,” stated Lynn Hearn, an lawyer with the Florida Well being Justice Undertaking, a nonprofit authorized assist and advocacy group that along with the Nationwide Well being Regulation Program represents the class-action plaintiffs. “To at the present time, we don’t know that the issues have been absolutely corrected. The moms of this state deserve higher from their authorities.”
Medicaid is the most important insurance coverage payer for childbirths in Florida, overlaying practically 98,000, or 44%, of all deliveries in 2022, in response to the state well being division. However it’s unclear what number of moms have been lower from the Medicaid protection they have been entitled to obtain. Florida’s Division of Youngsters and Households on Sept. 9 cashed a verify from KFF Well being Information to cowl the processing price for information it requested about eligible moms who have been disenrolled. As of Nov. 22, the state had not launched the information.
The state did present an estimate through the trial, however that quantity was not made out there by the state to KFF Well being Information. In a courtroom submitting, the plaintiffs cited the state’s estimate as displaying that 19,802 girls have been faraway from being pregnant protection as of March 2024, one 12 months after Florida started unwinding. It’s unclear what number of of those girls misplaced protection incorrectly. The determine might be a conservative estimate — it excludes anybody who was faraway from protection due to paperwork points.
Mallory McManus, deputy chief of employees for the Division of Youngsters and Households, informed KFF Well being Information that after figuring out the issue, company employees “manually corrected circumstances till essential system updates have been in place.” She added that the division additionally reviewed the system to “guarantee there have been no gaps in protection.”
McManus stated that Floridians who have been disenrolled from Medicaid “have been correctly observed and supplied with data on requesting an attraction.”
Rokx, Taylor, and Mezquita in the end regained their Medicaid protection after looking for assist from the Florida Well being Justice Undertaking. Attorneys there have stated they’re usually in a position to get protection restored for eligible individuals by reaching out on to the state company’s basic counsel — an avenue not recognized to most Floridians.

Whereas the class-action lawsuit awaits a judgment, the issues revealed at trial echo these encountered in different states with Deloitte-run Medicaid eligibility techniques, similar to Arkansas, Colorado, Florida, Georgia, Kentucky, Michigan, Pennsylvania, Rhode Island, Tennessee, and Texas.
In Texas, in response to a July report by the U.S. Authorities Accountability Workplace, “about 100,000 eligible people had been disenrolled attributable to eligibility system errors,” together with denial of postpartum protection for some eligible girls.
The error-plagued techniques and widespread denials of Medicaid for eligible individuals have caught the eye of lawmakers on congressional committees that oversee social applications. They blame state leaders who they are saying aren’t holding distributors like Deloitte accountable.
“Because the errors compound, contractors are rewarded with extra billing hours and better payouts,” stated Rep. Lloyd Doggett (D-Texas). “That is an alarming and unacceptable waste of taxpayer {dollars}.”
Sen. Ron Wyden (D-Ore.), chairman of the Senate Finance Committee, which oversees Medicaid, stated that too many individuals “can’t even get in by means of the entrance door attributable to outdated and inaccurate eligibility techniques.”
And Rep. Kathy Castor (D-Fla.) stated that “there’s such a sample of attempting to discourage and inappropriately chopping households off of Medicaid in Florida.”
“It seems to be intentional,” she stated, “and I feel it clearly is.”