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No Action On Medicaid Expansion Could Leave Working Poor Behind

Steve Nakatani
Flickr / Creative Commons

Florida is one of 21 states that have decided not to expand Medicaid with federal money. The decision, however, could leave behind the state’s working poor, while most other people benefit from the new health care law.

One of the many Floridians that could be left behind is Michael Orawe, 45, from Punta Gorda. He has three children he’s raising on his own.

Orawe is a part-time employee for a convenience store chain. His employer doesn’t offer him health insurance.

He said not having insurance is a constant worry for him

“Knock wood, I’m fairly healthy,” Orawe said. “But, you know, things can change in a heartbeat. It’s always on my mind that if something really bad were to happen to me I would really, really be in bad shape.”

A statewide health care advocacy group reached out to Orawe several months ago. They told him he’s among more than a million people in the state who would qualify for Medicaid under new rules created by the 2010 health care reform law.

However, he would only be eligible if lawmakers were to accept the millions of dollars the federal government set aside for the state to expand its program.

Because of a Supreme Court ruling last year, states can decide whether or not to expand Medicaid to more of their poor residents.

This past legislative session, Florida lawmakers decided not to expand Medicaid in the state.

The lawmaker representing Orawe in the Florida Legislature is Rep. Ken Roberson, R-Punta Gorda.

Roberson happens to sit on a Republican-led, 17-member panel that makes decisions on how the state will implement the health care law—including, whether or not to expand Medicaid.

“The House decision not to expand, I mean we made it, it was a deliberate and thoughtful decision after we gathered all the facts,” Roberson explained.

Roberson said his argument for why he voted not to give Orawe, and others, Medicaid is simple: he wants more people to have private insurance, not government-managed care like Medicaid.

“The private coverage gives better value for the patients,” he said. “It’s better access and better choices and one of the things that you are trying to do is take care of the needy and Medicaid has always been a safety net, not a mechanism to provide coverage for everyone.”

However, Leah Barber-Heinz, the advocacy director for Florida CHAIN, said the health care law is not written to expand Medicaid to everyone. Florida CHAIN is a health care advocacy group that has been working to get Medicaid expansion in Florida.

Barber-Heinz said many of the more than 1 million people that would qualify for Medicaid are the working poor, which is a segment of the population in Florida that has been growing in the past several years.

“These are very hard working people that are unable now to access health care,” she said. “And what happens then is there’s no preventative care and people end up with major catastrophic illnesses that could have been prevented.”

Barber-Heinz said this drives very sick people to emergency rooms, which makes health care costs skyrocket. That’s why the Obama administration wanted to expand Medicaid to more people in the first place.

She said her biggest challenge is battling an ideological divide that has many of the Republicans in the Florida Legislature vehemently opposed to things like Medicaid and federally-funded health care.

However, Orawe said getting Medicaid is not about ideology for him. It’s about peace of mind.

“That would be a nice cushion to have,” he said. “It’s one less thing to worry about—and there are so many things to worry about. Health, of course, is a major thing to worry about, especially since I am the sole bread winner. My girls look up to me every day to get up healthy, happy, wise, get to work, bring home the bacon.”

Gov. Rick Scott has said he supports expanding Medicaid in the state, but he has not put his political muscle behind it. Scott could even call a special session anytime between now and January, when the Legislature reconvenes.

Florida Senate leaders have said they are willing to work out a plan to accept the federal money and use it for offering private insurance.

However, the more conservative Florida House has said they are opposed to even taking the money.

As of now, there is no sign the two chambers are willing to work out a deal.