June 22, 2021

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

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 are Floridians 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 since 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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