Saying that notices sent by the state "border on incomprehensible," attorneys for Medicaid beneficiaries fired back this week in a potential class-action lawsuit alleging Florida has not provided adequate information before dropping people from the health-care program.

The plaintiffs' attorneys are asking U.S. District Judge Marcia Morales Howard to issue a preliminary injunction that would require reinstating coverage to people dropped from the program in recent months and ending additional terminations until adequate information is provided.

"Due process guarantees an adequate notice that 'fully informs' the enrollee of the case against them so they can decide whether to request a pre-termination hearing," the attorneys wrote in a 15-page brief Monday, partially quoting a legal precedent. "The notices in this case border on incomprehensible. As a result, people incorrectly decide not to appeal, or lose the right to benefits pending appeal, and must then scramble to figure out next steps."

The lawsuit, filed in August in Jacksonville, stems from a process that the state started this spring to determine whether more than 5 million people enrolled in Medicaid remained eligible for benefits. The process was a result of the end of a federal COVID-19 public-health emergency.

A filing this month by attorneys for the state said 2.5 million "redeterminations" had been conducted since April, with more than 1.7 million people found eligible and nearly 830,000 found ineligible. The redetermination process is expected to continue for months.

The Oct. 6 filing by attorneys for the Florida Agency for Health Care Administration and Department of Children and Families disputed that the state had violated beneficiaries' rights and said the judge should deny the plaintiffs' requests for an injunction and to treat the case as a class action.

"Plaintiffs' requested injunction upsets the apple cart with respect to millions of people: those who were found ineligible for full Medicaid whom plaintiffs demand be reinstated, and those for whom eligibility re-determinations would be halted during the pendency of this litigation," the state's attorneys wrote. "DCF's (the Department of Children and Families') administration of a multibillion-dollar program cannot simply pivot overnight to accommodate chaos of that magnitude."

An Oct. 30 hearing is scheduled.

The federal government declared the public-health emergency in 2020 as the COVID-19 pandemic began. Medicaid is jointly funded by the federal and state governments. As part of the emergency, Washington agreed to pick up more of the tab for the program.

But in exchange for the extra money, states had to agree that they wouldn't drop people from the Medicaid rolls during the emergency. Florida's program grew from about 3.8 million beneficiaries in January 2020 to nearly 5.8 million in April of this year, at least in part because people who might not otherwise be eligible for coverage could not be dropped.

With the end of the emergency, the state began redeterminations, and the Medicaid rolls had dropped to about 5.25 million in August, according to data on the Agency for Health Care Administration website.

But the lawsuit, advocacy groups and Democratic lawmakers have criticized the process and what they say is a lack of adequate notice before benefits are cut off.

"Defendants' (the state agencies') primary argument seems to be that the content of DCF's termination notice does not matter because the wild goose chase triggered by that notice (e.g., repeated calls to the call center, sorting through previous notices from months before, and general statements of program information), could eventually amount to adequate notice if an enrollee gets accurate information from DCF staff and figures out how to put all the puzzle pieces together," Monday's brief said. "The court should reject this version of due process because it ignores controlling law."

But state officials last week defended the process while testifying before the state Senate Health and Human Services Appropriations Committee.

"Our top priorities here are that we want to ensure that if you are eligible, you maintain your coverage and if you're not eligible, that you are provided with alternative options for what may be available for you to choose from," Casey Penn, a deputy secretary of the Florida Department of Children and Families, told lawmakers.

The plaintiffs in the lawsuit are a mother and daughter from Jacksonville and a mother and daughter from Miami-Dade County. Their full names are not included. The Agency for Health Care Administration runs most of the Medicaid program, but the Department of Children and Families is heading the redetermination process.

Jim Saunders reports for the News Service of Florida.

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