Each year lawmakers forgo Medicaid expansion, state residents pay the price

Activists demonstrate in a Florida state House office in Miami, in support of expansion of health care coverage. Photo by Joe Raedle/Getty Images.

Thirty-seven states have recognized the numerous benefits of increasing access to health care through Medicaid expansion.

In expansion states, all adults with income up to 138 percent of the poverty level have access to things such as life-saving medications, mental health treatment and wellness visits.

However, Florida leaders — despite our state’s high uninsured rate and poor health and wellness indicators — have steadfastly rejected this policy choice. It has gotten to the point where they will not even bring it up during legislative session.

And while recent funding in the budget for things such as mental health care and fighting the opioid epidemic should be applauded, they are piecemeal solutions to Florida’s growing health care crisis.

Each year that lawmakers forgo Medicaid expansion, state residents pay the price.

One such Floridian is Carie S. She is raising two children and working full-time at a job that pays $11/hour. She has bipolar disorder, rheumatoid arthritis and fibromyalgia.

Carie is currently living without any of her medications and says that she has “learned to deal with the physical pain,” but that it’s “the mental health that’s the most difficult to live with and manage.”

Carie previously received Medicaid benefits, but lost her health care coverage when her wages increased, and Florida’s extremely low Medicaid income limit kicked in.

The Sunshine State’s threshold is just 32 percent of the poverty level for parents and caretakers — only $6,825 for a family of three.  [Adults without children are unable to qualify for Medicaid benefits at any income level.]

When workers living on low wages lose Medicaid benefits but are not offered coverage through their employers, they lose a critical work support. People with chronic conditions need access to care to support their continued participation in the workforce and in times of joblessness to help keep them healthy so they can look for work.

And contrary to the stereotypes, most adults — 60 percent — who are currently covered or could be covered through Medicaid expansion are already working. Those who don’t work are primarily people with illnesses or disabilities, students, or caretakers for a family member.

In Florida, uninsured workers who are paid a low wage are often employed in the service and tourism industries, part of the labor force vital to Florida’s economy.

Yet, a growing body of research shows that because they are living in a non-expansion state, they are at much higher risk of dying prematurely due to lack of care for conditions that are very treatable, such as diabetes, heart disease and cancer.

Researchers project that more than 2,700 Floridians aged 55 to 64 lost their lives between 2014 and 2017 because the state has not expanded Medicaid.

There are nearly 500,000 residents in our state who are trapped in the “coverage gap.” They have income below the federal poverty level, which is too low to qualify for tax credits and federal marketplace subsidies, but their wages are considered too high in Florida to be eligible for Medicaid benefits.

“Sick in Paradise,” a project of the Medicaid Matters for Florida coalition, features stories from residents across the Sunshine State who — like Carie — are unable to get or keep health care coverage under Florida’s low income-threshold for Medicaid.

The website also invites Floridians to share their own experiences trying to access affordable medical care.

It is time for state leaders to acknowledge that Medicaid expansion is a sensible policy choice for Florida.

Authors are Sadaf Knight, CEO of Florida Policy Institute; Louisa McQueeney, program director of Florida Voices for Health; and Miriam Harmatz, executive director of Florida Health Justice Project. Together, these three groups lead the Medicaid Matters for Florida coalition.