Los expertos en políticas de salud están destacando una multitud de inquietudes con respecto al proceso de redeterminación de Medicaid de Florida, alegando que está dando como resultado una falta de cobertura para niños y familias elegibles.

Durante una convocatoria de medios el martes, los defensores argumentaron que a pesar del plan declarado por el Departamento de Niños y Familias de Florida para manejar la resolución de la emergencia de salud pública, la realidad ha estado marcada por el caos y la confusión.

Los datos oficiales publicados a finales de julio por CMS muestran que en el primer mes después de que terminaron las disposiciones federales de cobertura continua para Medicaid, 249,427 floridianos fueron dados de baja, el 82% de los cuales tenían sus casos cerrados por razones de procedimiento o "burocracia", como la falta de respuesta a un aviso.

Erica Monet Li del Instituto de Política de Florida, dice que el tiempo de espera del centro de llamadas del estado se encuentra entre los peores de los 17 estados que iniciaron redeterminaciones en abril.


"El 48% de las llamadas realizadas al DCF fueron abandonadas y el tiempo medio de espera para un primer contacto fue de 40 minutos antes de ser derivado a otra línea de ayuda," informa Monet.

El Departamento de Niños y Familias de Florida ha publicado una guía en su sitio web, sin embargo, los defensores dicen que algunos enlaces a la asistencia legal no funcionan, la traducción del inglés al español es confusa y necesita mejorías, y dicen que el sitio web debe modernizarse con una opción compatible con dispositivos móviles para facilitar la navegación de los floridanos.

Según los Centros de Servicios de Medicare y Medicaid, todos los estados deben presentar una estrategia para agilizar la reinscripción y reducir las pérdidas de cobertura.

Joan Alker, del Centro para Niños y Familias de Georgetown, señala que un mecanismo denominado renovaciones "ex-parte", destinado a simplificar la verificación basada en los ingresos y las renovaciones automáticas, sólo se está aplicando en Florida en aproximadamente un 19%.

Ella expresa su preocupación por la posibilidad de que los métodos de procesamiento del estado justifiquen una investigación.

"Debido a que Florida tiene una tasa ex-parte baja y una proporción relativamente alta de niños, Florida puede ser uno de los estados que está siendo investigado por este problema y esperamos que la aplicación de CMS lo siga," dice Alker.

Los defensores dicen que es difícil navegar por un proceso tan complejo y piden a los funcionarios de Florida que emitan una pausa en las redeterminaciones hasta que solucionen los problemas o puedan ejecutar adecuadamente el plan del estado.

Lynn Hearn del Florida Health Justice Project, que tiene un tablero en su sitio web para rastrear el proceso de redeterminación, dice que escucha muchas historias de personas que están confundidas acerca de los avisos del estado.

"El aviso tampoco indica claramente como apelar correctamente," subraya Hearn, "las instrucciones de apelación están perdidas en el aviso, después de un aviso de varias páginas, después de una página completa de códigos QR para otros programas potencialmente irrelevantes."

Florida es el único estado que no ha aprovechado las flexibilidades ofrecidas por los Centros de Medicaid que solucionarían problemas comunes, y los grupos instan a los líderes de Florida a centrarse en solucionar los problemas actuales para garantizar que los niños y las familias del estado que reúnen los requisitos no se queden sin la cobertura necesaria.

People who are part of the Deferred Action for Childhood Arrivals program, known as DACA, will be dropped from their CoveredCA health plans at the end of August.

The move comes after the Trump administration changed a Biden-era definition of "lawfully present" to revoke health care eligibility for thousands of immigrants.

Christine Smith, policy and legislative advocate for the nonprofit Health Access California, said people only have a few weeks to get medical appointments in before their coverage ends.

"If you're enrolled in Covered California and you're a DACA recipient, the Trump administration just ended your coverage," Smith emphasized. "People should use as much of your health care as you can before the August 31st deadline."

The Centers for Medicare and Medicaid Services defended the move, saying it will save taxpayers money. CoveredCA estimated the change affects about 2,400 DACA recipients in the state who make too much to qualify for Medi-Cal and have jobs not providing health insurance. They can still buy private insurance but it is much more expensive. People who prepaid for their coverage can seek a refund.

Smith predicted it will be a blow not just to those who lose coverage but to the state's health care system as a whole.

"The lines in the ERs are going to be longer because people are not going to be able to get affordable preventive care," Smith projected. "They're just going to get sicker and then end up in the ERs. People will overall incur more medical debt. Hospitals will have more uncompensated care."

The change is nationwide. As of mid-July, about 538,000 people in the DACA program across the U.S. are ineligible to enroll in any state-based insurance marketplace and are unable to access premium subsidies or cost-sharing assistance.

Artificial intelligence is appearing more prominently in many aspects of life and research suggests older populations are curious, yet remain wary of using the technology in their everyday lives.

According to Stats Indiana, there are more than 1.5 million Hoosiers aged 65 and older, or 18% of the state's population. Experts said it is likely the demographic will use AI in some form in the next few years, either by choice or necessity.

Dr. Shaun Grannis, vice president of data and analytics for the Regenstrief Institute on Aging, said AI offers real benefits.

"It can reduce loneliness through conversation, provide reminders for medications and appointments," Grannis outlined. "It can support cognitive stimulation via games, storytelling, news updates."

The technology can also offer a low-pressure way to access information on public services, he added, which is valuable for those with mobility issues or those who feel intimidated by technology.

Grannis cautioned any tool which can be used for good can also lead to problems. He noted AI can create a false sense of companionship and mask social isolation. Overdependence is a legitimate concern, he argued, if the technology becomes a "crutch" for all forms of interaction.

"All cognitive activities or decision-making, it can actually lead to and create a negative feedback loop, lead to a decline in engagement and even basic self-management skills," Grannis explained. "This is risky."

Grannis believes one solution is designing AI systems to complement, not replace, human interaction. He stressed it can be done though building broader support ecosystems including family, friends, caregivers and community services. Grannis emphasized it would encourage real-world activity, prompting the user to go for a walk, call a grandchild or attend a local senior event.

If you have an extra five minutes, you can save a life because you can learn cardiopulmonary resuscitation at no cost from a new mobile, hands-only CPR kiosk.

The new kiosk is in the lobby of Saint John's Health Center in Santa Monica. The machine's touch screen gives a brief overview of hands-only CPR and you can practice right there, on a mannequin.

Dr. Rigved Tadwalkar, cardiologist at St. John's, said it is an easy way for people to get more comfortable giving chest compressions in an emergency.

"It's a lot like a video game but of course, a lot more important than a video game," Tadwalkar pointed out. "It gives real-time feedback about the depth and rate of compressions, proper hand placement, which are all factors that influence the effectiveness of CPR."

The American Heart Association operates the St. John's mobile kiosk and a stationary model at L-A-X with support from the hospital. Santiago Canyon College in Orange County also has a mobile hands-only C-P-R kiosk now through September, sponsored by Edwards Lifesciences.

Steven Munatones, an Orange County business owner, said he survived what's known as a "widowmaker" heart attack which led to cardiac arrest nine years ago, thanks to his 17-year-old son, who gave him immediate CPR with instructions from a 911 operator.

"You don't have to put your mouth to anybody's mouth," Munatones explained. "You just put your hand on their chest and pump. He saved me, and others can do the same, anywhere. So, it's absolutely a lifesaving, heroic act that anybody can do."

Statistics show 350,000 Americans suffer from cardiac arrest outside a hospital each year and about 90% die, in part because they do not receive CPR. About 70% of those cardiac arrests happen at home, so people often depend on family or friends to give CPR before an ambulance arrives.