In the middle of the night, Genesis Rodriguez struggles to breathe. The 20-year-old's life-long battle with asthma often wakes her from sleep. As a Miami resident without health insurance, she faces alarming health and financial risks. Unfortunately, Florida's legislature has come between Genesis and her health.
Almost two years have gone by since Governor Rick Scott, an avowed Obamacare opponent, shocked the state by announcing his support for accepting vast federal funds to expand health care access to low-income Floridians. Despite his vocal approval and a related bill passed by the Florida Senate, the Florida House failed to act, leaving billions of dollars languishing in federal coffers--and out of reach of Florida's taxpayers.
Florida is now caught in a crisis of its own creation. The Affordable Care Act sought to make insurance more affordable through two avenues: billions of dollars in federal funding to supplement state Medicaid programs for low-income adults to receive free coverage, and tax credits that function as a discount on plans purchased by middle-income people who make too much money to qualify for Medicaid.
Since Florida decided to reject federal funding to close the health coverage gap, low-income adults like Genesis who would have been covered through Medicaid cannot afford health insurance. They don't make enough money to qualify for tax credits intended for middle-income people. In many states, Genesis would face a far better situation. A 21-year-old with an annual income of $12,000 in states that have expanded Medicaid could qualify for tax credits to buy a plan for just $20 a month. If that person makes $11,000 per year or less, he or she should qualify for free coverage. But that's not the case in Florida: nearly one million Floridians fall into this health coverage gap.
Florida's failure to act hits young adults, ages 18 to 34, extremely hard. More than one-third of young Floridians in the health coverage gap are young adults. That's no surprise considering that one in four Floridians aged 18 to 34 live in poverty. Millennials are trapped in a super storm of economic risk--they're facing rapidly rising tuition costs, high rates of unemployment and consequently, and they have a tough time affording medical bills. Given that Millennials end up in the emergency room more than any other age group, except the elderly. This is a major concern, but one that can be alleviated.
Lawmakers can have their free-market cake and eat it, too. The Affordable Care Act allows states to use these federal funds to pay for private health insurance programs to cover some low-income adults (rather than public programs like Medicaid). Lawmakers who oppose public health care programs can, in good conscience, accept federal dollars to pay for private plans. Indeed, that's the route chosen by Arkansas and the model passed by Florida's Senate.
And yet, affordable coverage stays out of reach for Floridians least able to pay for it. During his 2014 campaign, Governor Scott reaffirmed his support for closing the coverage gap, noting that he would sign a bill to accept funding, should one reach his desk. Newly reelected, he should throw his weight behind closing the coverage gap, and build a coalition of conservative and liberal politicians to provide access to affordable health coverage for all Floridians.
Governor Scott must act quickly. Earlier this month, Florida lawmakers returned to the Capitol to take their oath of office and begin preparations for the 2015 legislative session. Already, lawmakers are gearing up for yet another battle over the health coverage gap. With support from leadership, both sides could be spared a lengthy and contentious debate and craft a solution to fit Florida's needs.
For now, young adults like Genesis will try to make ends meet until lawmakers give her a little breathing room.