With high rate of uninsured, Florida prepares for health care reform

By Mc Nelly Torres

From Florida Center for Investigative Reporting

The numbers are deplorable.

One of every 13 uninsured kids in the United States lives in Florida.

About 500,000 children in Florida have no access to health care services, even if they are eligible for state-funded health care coverage due to their parents’ low income.

Nearly half of those 500,000 children live in one of six counties – Miami-Dade, Hillsborough, Broward, Palm Beach, Orange and Duval.

The disparities in health care access and coverage for low-income and working families, and particularly for children, are striking in Florida, which at 13.8 percent has the fourth-highest rate of uninsured children in the nation. Nevada, Texas and South Carolina have higher rates.

The Affordable Care Act could change these disparities, or at least close the gap by providing universal health care coverage to families. Supporters of health care reform say this will prevent higher health care costs in the long run.

This was the discussion with five health care experts who participated Tuesday in a panel discussion about health care reform in Florida at the United Way in Miami.

During the talk, Laura Goodhue, executive director of Florida Community Health Action Information Network, or CHAIN, said health care reform highlights access to care, including the many uninsured children in Florida who are eligible for these programs.

"The reason why we are focusing on kids right now is because the attention they are giving to adults," Goodhue said. "When the adults start signing for insurance, it would give us opportunities to talk about kids and get them into the system."

The discussion focused on how health care reform will affect children in the state and addressed the expansion of the Medicaid program to include all adults newly eligible under the Patient Protection and Affordable Care Act. The panelists also discussed a proposed measure submitted to the state legislature to remove the five-year waiting period for children of legal immigrants to be eligible for the state’s KidCare program coverage.

The roundtable discussion – which was organized by New America Media, the nation’s largest association of ethnic media outlets, and funded by The Atlantic Philanthropies – came a week after Gov. Rick Scott reversed his earlier position and recommended the expansion of Medicaid in Florida. Scott’s decision could have a remarkable impact in Florida, where as many as 1.2 million Floridians may be eligible to enroll in private managed-care plans. If the Republican-controlled legislature approves Scott’s plan next month, Florida will become one of the largest states to extend health care coverage to the working poor.

Scott is one of seven governors in recent months to announce plans to expand Medicaid. The others include New Jersey Gov. Chris Christie, a Republican who made his announcement this week, as well as the governors of New Mexico, Arizona, Michigan, Nevada, North Dakota and Ohio.

Medicaid expansion, an investment

Supporters of health care reform and Medicaid expansion believe this move will save lives through preventive care and pump millions of dollars into the state’s weak economy, creating tens of thousands of jobs.

"We can’t afford not to expand Medicaid because of legislative barriers that have been put in place," said Karen Woodall, executive director of Florida Center for Fiscal and Economic Policy, a nonprofit organization that researches how state fiscal and economic policy affects low- and moderate-income individuals, families and businesses.

"And there’s this notion that the money will go to a hole somewhere," Woodall continued. "But that amount of money will go straight to the economy and will give a much-needed economic boost in the state, creating 60,000 jobs for the first year and up to 80,000 the following year."

According to Woodall, Florida will gain at least $20.3 billion in federal money in the next 10 years, which will allow for expansion of health care coverage to low-income workers in a state where the tourism and agriculture industries have more than 2 million low-wage jobs.

"You are talking about half a million people who are working but are uninsured," Woodall said, noting that Medicaid expansion will make these workers eligible for coverage.

Florida will save up to $100 million per year by accepting the federal money for Medicaid expansion, according to a study by the Center for Children and Families at Georgetown University.

"That’s because uninsured people do get some care today and the state is paying for that, but unfortunately what they are not getting is preventative and primary care, so they end up sicker, bankrupting themselves and showing at emergency rooms," said Joan Alker, a Georgetown University professor and co-director of the Center for Children and Families.

Healthcare coverage for children of legal immigrants

In 2009, Congress gave states the option to allow children of legal immigrants to qualify for Medicaid and the Children’s Health Insurance Program, or CHIP, without the five-year waiting period that applies to most public assistance programs for immigrants. Today, 21 states allow legal immigrant children to enroll in Medicaid and CHIP without waiting.

Diana Ragbeer, director of public policy and communications for the Children’s Trust of Miami-Dade, said the group supports a proposed measure, SB 704, sponsored by state Sen. Rene Garcia (R-Hialeah), which would remove the five-year waiting period and allow an estimated 20,550 legal immigrant children to enroll in KidCare this year. A similar bill, HB 4023, sponsored by state Rep. Jose Felix Diaz (R-Miami), is before state House.

"These are families who are working and paying taxes here. They live here and are spending money in Florida," said Ragbeer.

Experts said unspent state funds are already earmarked for children’s health coverage as well as money freed up as a result of increased federal matches. That means the state has at least $39.1 million available to cover these new costs.

Ragbeer and the other panelists said a lack of health care coverage to uninsured children, including those of legally residing immigrants, leads to delayed health needs that require more expensive treatment in the future.

"It’s a matter of removing the barrier that has been in place for these children so they have a bite from the apple," said Woodall. "We are paying for these kids anyway and we’ll pay more when they show up in the emergency room. Bottom line is that we have the money in the system."

The event also attempted to dispel myths about the Affordable Care Act and educate the public about how health care reform will affect Florida.

"These changes will go a long way to make sure children and adults will get enrolled and stay enrolled," Goodhue said. "The law is about streamlining the process and allowing access to health care."

Ragbeer agreed, stating, "When the whole family is covered, it becomes a lifestyle, because they make appointments for checkups and all have access as opposed to taking the child to the ER when he or she is sick."