Anne Swerlick
June 22, 2021

Congress Must Act to Help Thousands of Floridians in the Medicaid Coverage Gap  

This post was last updated on September 29, 2021. As new policies are announced, FPI will update this page.

As Florida’s response to COVID-19 takes front and center, concern grows for low-income families who struggle to take precautions against the spread of the virus. Although Congress has passed the Families First Coronavirus Response Act to address, at least in part,  the public health crisis and economic fallout from COVID-19, many barriers continue to keep struggling families from accessing the assistance they need during the pandemic. As Florida initiates policies implementing the Act and addressing other barriers to the safety net, FPI will update this form. When available, hyperlinks are provided to agency documents or statements that provide greater detail  about the new policy.

On March 22, 2020, FPI and 44 other organizations sent a letter to Governor DeSantis, leadership in the Legislature and agency heads to urge action on 47 specific policy changes to reduce unnecessary barriers for Florida’s safety net programs in response to the COVID-19 pandemic. See the letter here.

Another legislative session has ended, with state leaders once again refusing to expand Florida’s Medicaid program to adults with income up to 138 percent of the federal poverty level ($17,784 for a single adult, $30,312 for a family of three). Florida is one of just 12 “non-expansion” states.  

Thus, thousands of Floridians continue to fall into the Medicaid coverage gap. They have income too low to qualify for subsidies to purchase insurance in the Affordable Care Act (ACA) marketplace and too high to qualify for Florida Medicaid.  

Florida’s Coverage Gap: By the Numbers

A recent report from the Center on Budget and Policy Priorities includes data on the diverse group of 425,000 Floridians caught in the gap: 

  • 266,000 Floridians are in the labor force, including 98,000 workers in essential or front-line industries, such as health care and food production.  Most adults in the coverage gap work or have caregiving responsibilities. Many face structural barriers to finding consistent work, their jobs are less likely to offer health insurance, and their income fluctuates, which can force them into and out of eligibility. 
  • 108,000 are parents with children at home. Florida has high and growing numbers of uninsured children. Extending coverage to parents boosts enrollment among eligible children, increasing their access to preventive care and improving their health outcomes as they reach adulthood and beyond.  
  • 130,000 are women of reproductive age.  Women who are pregnant can apply for coverage through Medicaid. Many women who are not pregnant, however, cannot qualify, are uninsured, and unable to access vital health care services. 
  • 126,000 are older Floridians (aged 55-64). Research shows that 2,776 older Floridians died between 2014 and 2017 because the state has not expanded Medicaid, a number that has undoubtedly grown 2017.  People in their 50s and 60s, especially those with low income, are much more likely than younger adults to have serious, chronic health conditions. 
  • 54,000 have disabilities. Many people do not meet strict state or federal standards for disability that now must be met to qualify for Medicaid. This includes people with serious cognitive problems, and difficulties with basic physical activities such as walking, carrying, or climbing stairs. With expansion they could qualify for Medicaid just based on having low income.  

Hundreds of studies show that Medicaid expansion improves coverage and access to medical care, prevents premature death, and protects against financial insecurity. It is time for uninsured adults across all states to have access to these lifeline benefits.  

The next economic recovery package needs to include provisions that would ensure permanent, comprehensive federal coverage to close the health care coverage gap in Florida and the other 11 non-expansion states. 

This would be an overdue leap forward on the path to health care justice for all. 

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Expanding Medicaid Eligibility

A million Floridians would gain access to health care

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