For two years, Florida legislators have refused to expand Medicaid as envisioned under the Affordable Care Act. Their decision left an estimated 850,000 Floridians without healthcare insurance in the “coverage gap.” Those caught in the gap earn too much to receive Medicaid, but not enough to qualify for subsidies to buy a plan through the federal marketplace. The Miami Herald looks at how these Floridians are coping and what other states are doing to close the gap.
Reports
For 850,000 Floridians, piecemeal healthcare
With legislators seemingly deadlocked on Medicaid expansion in Florida, residents in the “coverage gap” are stitching together their medical care through personal ingenuity, half doses of medicines and low-cost clinics. It’s exhausting work, especially when you’re sick. Read more
Choosing between dinner and a medical test
Without Medicaid expansion, South Florida’s low-income residents have found out the hard way that the healthcare safety net designed to catch people before they hit bottom is no substitute for insurance. Read more
Why won’t Florida adopt Medicaid expansion?
Other states have overcome political opposition to Medicaid expansion and adopted plans to bring government-subsidized coverage to more of their low-income residents. Read more
Explainer: How 5.2 million people fell into the health insurance coverage gap
Compare states that expanded Medicaid with states such as Florida that did not expand, leaving citizens without coverage. Read more
Resources
Map: Find a low-cost healthcare provider
For the uninsured population, affordable care is limited to free clinics, which are often operated by churches or schools, and federally qualified health centers, organizations that receive grants from the federal government to care for underserved populations. Look up a facility in South Florida. Or see a list of local agencies that help with social and medical services.
Profiles
For people caught in the gap, injuries can be catastrophic and chronic illnesses may go untreated for years. How did 850,000 people find themselves in the gap, and how are they coping? Here are some of their stories.
When the caregiver can’t get care
“I feel left over, left back.’’ — Paula Bazain, caregiver
Single mother of five $4000 short for coverage
“What kind of country are we? Everybody needs insurance” — Francesca Corr, single mother
A lifetime of respiratory illnesses
“I can’t live a normal life.’’ — Genesis Rodriguez, automotive tech student
Seven years without a checkup
“Normally, you go to the doctor when something like that happens.’’ — Carlos Cuervo, salesman
Covered under Medicaid, for now
“One minute you receive Medicaid, and the next minute it’s gone.’’ — Ceslynn Watkins, former customer service rep
Two heart attacks and living in an abandoned house
“I knew exactly right away what it was because I’d felt it before. I was having a heart attack.’’ — Eric Schmidt, former construction worker
A move from NYC to Miami, a loss of coverage
“It wasn’t the welcome that I wanted from Florida.’’ — Harry Melo, student
A career in construction, until a back injury
“They just tell me I’ve been denied. Every time.” —Timothy Lane, former landscaper
Piecing together medical care
“I wish I had insurance, so I can go to a private doctor.’’ — Cynthia Louis, waiting a year to see a specialist
A few years shy of Medicare coverage, and caught in the gap
“It’s totally unfair that when you’re in need of help, you can’t get it.’’ — Vanessa Wilcox, former phlebotomist
Loss of income could mean loss of eyesight
“They won’t give me a chance. That’s not right. … I can go blind.” — Edith G. Camacho, homemaker
Diabetic relies on emergency room for care
“I would benefit more from Medicaid expansion than charity care.’’ — Vincent Adderly, former security guard
Filed under: General Problems
Sometimes it just comes down to:
We can’t afford YOU. And by ‘we’ I mean the American taxpayer. By ‘you’ I mean, well, you who are trying to get Medicaid.
It’s unfortunate that there are too many people on Medicaid or trying to get Medicaid. That fact is suggestive of a larger problem that the taxpayers should not have to bear.
In asking the states to expand Medicaid, the effect was asking the taxpayers of the state to pay more taxes. In a lot of states, like mine, the taxpayers said no.
It’s sad. The whole situation of these people is sad. But I will be gosh-darned if I am going to pay one more cent than the $7,000 I am paying in deductibles and premiums so others can have all the healthcare needed for a $3 copay.
Just, no. I can barely afford my own family. Sorry.
When you or someone in your family becomes one of those unfortunate people who cannot afford health insurance, maybe you’ll sing a different tune.
If you had a disabled child and could not afford the treatments for that child, maybe you’ll change your mind about Medicaid.
If a drunk driver crashes into your car, injuring you to the point of disability and you can’t ever work again, maybe you’ll feel differently about Medicaid.
If you happen to be one of about 400,000 people who are maimed by the medical industry every year, maybe the Medicaid program will then look good to you.
Or if you or someone in your family is harmed by someone who suffers from mental illness but could not afford treatment, maybe you’ll become a cheerleader for Medicaid.
In the meantime, maybe we should all be hoping for a national health care system so Americans aren’t fighting against each other for proper health care.
Actually, I was there two years ago. My then 13 year old son received a diagnosis of Crohn’s disease. We had insurance, but that insurance came with a whopping $12,500 deductible.
When that happened, Medicaid never crossed my mind. My husband and I sat down and thought of ways to get ourselves out of this box all while staring down decades of very expensive treatments. Again, we never thought of Medicaid. We did what we always do, which is find out what we can cut from the budget and make payment arrangements. And we bought better insurance the following year – hence the $7,000 in insurance premiums I mentioned earlier. I am also still paying each month for that hospital bill.
Medicaid is a safety net system. And yes, thinking back, I was in a position to most likely qualify, but I never saw myself as in as dire straights to submit to it. We could work it out.
We were not that bad off as to ask the taxpayers to foot our bill due to our lack of planning and poor insurance choices. Not fair. No one else should have to pay for my bad life choices.
What happens now, and why people are on Medicaid mostly, is because they are poor. Not because they have had some crazy stuff happen like you mentioned. No, they are poor. Once on Medicaid, they are on it for life. Decades. That is not a safety net. That’s a catch all.
My point in all this is that yes, people need Medicaid for different reasons. Yes, it’s a great thing that the people have it. My point also is there are too many people on it and we the taxpayers can’t afford it. I can’t give another cent. I’m sorry and I will vote out anyone in my state that wants to expand it and hit my paycheck.
The people needing Medicaid is indicative of a larger problem that has nothing to do with healthcare. It’s economic. Like I said, they are poor. Fix that, and you fix Medicaid.
This new living wage movement may do just that. How many will drop off the rolls then? I’m anxious to see that fallout. It’s going to be epic.
Perhaps the difference between us lies in your belief that health care is a privilege, which it currently is, and my belief that health care is a right, which I hope it will be one day.
Just like the food we eat, the air we breathe, and the water we drink, we cannot survive without health care. And just like the air, water, and ground we all share, we share in each other’s health care — it’s called public health. For instance, someone with cancer who’s immune system is weak doesn’t want to go out in “public” unless people are vaccinated and not walking around with some communicable disease.
Sure, people can hide behind fences, walls, locks and masks — maybe some imaginary line on a map — but that’s not going to change the fact that we all share the same planet. We are all part of the public. I’d say people who ignore that fact do so at their own peril.
Anyone who thinks they can “fix” Medicaid isn’t talking about how well it works — just how much it costs. Perhaps we should spend even more money on war… that’s worked so well… And wouldn’t it be nice if everyone paid the same low rates as those on Medicaid and Medicare? But I guess that’s for other countries, not the good ‘ol U S of A.
And you should write to President Obama about how to “fix” poverty… racism too.
Aren’t two Florida politicians in the running for the GOP nomination? What is their position on this issue?
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Great post!