The COVID-19 pandemic brought about significant changes to various social programs, including the Supplemental Nutrition Assistance Program (SNAP). This article provides a comprehensive overview of how SNAP benefits were affected, particularly focusing on the period from March 2020 through the end of the federal public health emergency. Understanding these changes is crucial for individuals and families relying on SNAP to meet their nutritional needs.
Medicaid and the Public Health Emergency
From March 2020 until the end of the federal public health emergency, a significant provision was in place: Medicaid recipients generally would not lose their eligibility. This was a key component of the Families First Coronavirus Response Act, which stipulated that states obtaining an enhanced federal Medicaid match could not terminate coverage for recipients enrolled as of March 18th for the duration of the public health emergency, unless the individual was no longer a state resident or requested voluntary termination.
AHCA (Agency for Health Care Administration) worked to reinstate benefits for recipients who may have received termination notices in March 2020, ensuring continuous coverage during the crisis.
However, a new interim final rule issued by federal CMS on October 28, 2020, did weaken this continuous coverage requirement to some extent. While states like Florida, which cover full benefits for lawfully residing children in the first five years after entering the U.S., had to limit coverage to emergency services once those children turned 18, further changes required legislative action at the state level.
Redetermination and Recertification
As of October 1, 2020, the Department of Children and Families (DCF) began mailing letters for case reviews to check if households were still eligible for Medicaid and/or Medically Needy assistance. AHCA urged recipients to re-apply if they received these letters. Despite these reviews, Medicaid coverage was maintained throughout the COVID-19 Public Health Emergency. In January 2021, DCF conducted “automated renewals” for individuals whose sole income was Social Security and SSI, and were enrolled in an SSI-related Medicaid program.
Extended Application Time (Rescinded)
Initially, the time for submitting required documentation for Medicaid applications was extended to 120 days for applications filed in February 2020. Eligibility was still effective from the first day of the month the application was received. However, this policy was rescinded effective July 1, 2021. Medicaid applications submitted on or after this date may be denied on the 30th day after application or the day after verification information is due. Applications filed prior to July 1, 2021, were still allowed 120 days to provide verification.
Impact of Unemployment Payments
Additional unemployment insurance payments of $600/week under the CARES Act were excluded from income calculations for Medicaid eligibility. However, these payments were considered income when determining marketplace subsidy calculations for the Affordable Care Act.
Medicaid Service Coverage During the State of Emergency
During the state of emergency, Medicaid coverage was expanded to include:
- All medically necessary services for COVID-19 testing and treatment.
- Waivers on service limits to maintain the health and safety of recipients diagnosed with COVID-19 or to keep recipients safely in their homes.
- Waivers of copayments for all services.
- Waivers of limits on early prescription refills (except for controlled substances).
- Coverage of a 90-day supply of maintenance prescriptions when available at the pharmacy.
- Reimbursement of out-of-state providers offering medically necessary services to Florida Medicaid beneficiaries. (Provider “provisional enrollment” for in-state and out-of-state providers ended July 1, 2021).
- Delay of fair hearings in cases where the recipient continued to receive services pending the hearing’s outcome.
COVID-19 Vaccines for Medicaid Enrollees
In March 2021, Governor DeSantis revised the vaccine distribution plan, making all Floridians eligible to receive any FDA-approved COVID-19 vaccination.
Medicaid enrollees could find vaccine locations and schedule appointments through myvaccine.fl.gov. Transportation assistance was also available for Medicaid enrollees needing a ride to their vaccination appointment. Enrollees could contact their Medicaid plan or call the Medicaid Helpline at 1-877-254-1055 for transportation services. The state also launched an email system ([email protected]) to bring COVID-19 vaccines to homebound seniors.
Behavioral Health Services
AHCA loosened coverage restrictions for behavioral health services during the state of emergency. Prior authorization requirements for mental health or substance use disorder treatment were waived, and service limitations were lifted temporarily. However, service limits and prior authorization requirements were reinstated in July 2021.
Telemedicine
During the state of emergency, AHCA reimbursed providers for telemedicine well-child visits for children older than 24 months through age 20. Providers were directed to schedule follow-up in-person visits for immunizations and physical exams that couldn’t be done via telemedicine.
Public Charge Rule
The public charge rule was not applied to immigrants’ use of Medicaid benefits for COVID-19 testing and treatment.
Home and Community-Based Waiver Services (HCBS)
Florida obtained federal approval to modify HCBS waiver programs, including Long Term Care and Developmental Disabilities programs. These changes, effective retroactively from January 27, 2020, to January 26, 2021, included:
- Virtual evaluations, assessments, and care planning meetings.
- Lifting service limits.
- Adjusting service prior authorization requirements.
- Expanding service settings.
- Payments for support services in hospitals or short-term institutional settings.
- Visitor restrictions in residential settings.
COVID-19 Testing, Treatment, and Vaccines for the Uninsured
Florida did not opt to receive 100 percent federal Medicaid funding for COVID-19 testing, treatment, and vaccines for the uninsured under the American Rescue Plan Act. Consequently, uninsured Floridians relied on a patchwork of free resources. AHCA advised that uninsured individuals could receive free testing from county health departments or federally qualified health centers and encouraged individuals to confirm the availability of free testing prior to receiving services.
Residency Proof and Vaccine Access
Residency proof was no longer required at some vaccine sites, allowing access for migrants. A public health advisory specified that COVID-19 vaccines were available to Florida residents or those present in Florida providing goods or services for residents and visitors.
Affordable Care Act (ACA) Marketplace
In 2021, the ACA Marketplace re-opened to provide a special enrollment opportunity for those needing health insurance. The American Rescue Plan significantly reduced premiums for many with low or moderate incomes. Individuals receiving or approved for unemployment compensation for any week in 2021 could access free or reduced-cost health insurance plans through the ACA marketplace.
Conclusion
The COVID-19 pandemic significantly impacted SNAP and Medicaid benefits, leading to temporary changes and expansions in coverage. While some of these changes have been rolled back, understanding the landscape of benefits during the public health emergency is crucial for those who relied on these programs. Staying informed about current eligibility requirements and available resources is essential for maintaining access to vital nutritional and healthcare support. Contact Covering Florida at 877-813-9115 for assistance with ACA marketplace enrollment.
