Andrew Behrman, president of the Florida Association of Community Health Centers, which represents more than 40 health clinics statewide, said the more than $8 million in federal grants given to state health centers in May has led to the hiring of 400 outreach and education workers, including 100 in South Florida who also will help the uninsured learn more about their options for health insurance coverage under the law.
“We’re on the ground,’’ Behrman said. “We will be there for you.’’
Florida is ripe territory for the health law, according to data released by the U.S. Census Bureau in August, which reported that Florida has 3.8 million uninsured residents, the second-highest rate in the nation. Only Texas has a higher rate of uninsured residents. However, it is unclear if the Census count includes undocumented immigrants, who are not eligible for coverage under the health law.
Many of Florida’s uninsured will be eligible for some sort of health coverage under the Affordable Care Act, Sebelius said.
But state leaders have opposed the law, rejecting one of the key measures that could provide coverage to more than one million Floridians: the expansion of Medicaid, the state-federal health program for the poor and disabled.
The U.S. Supreme Court’s ruling on the health law in summer 2012 gave states the option to decide whether to expand eligibility for Medicaid to those earning up to 133 percent of the federal poverty level -- about $15,000 a year for an individual -- as called for under federal healthcare reform.
In Florida, an adult must have a dependent child and earn no more than 19 percent of the poverty level to be eligible for Medicaid.
Expansion of the program in Florida would cover an estimated 800,000 to 1.3 million residents who are now uninsured, according to a Georgetown University study. In Miami-Dade, expansion would cover an additional 150,000 to 225,000, according to the Georgetown projections.
Without Medicaid expansion, an estimated 995,000 Floridians will fall into the “coverage gap’’ — an area where people with poverty-level incomes do not qualify for Medicaid and cannot get federal subsidies to help buy health plans on the new online exchanges. Federal subsidies are only available for individuals and families living between 100 and 400 percent of the poverty level.
“They really will be without affordable options,” Sebelius said, noting that many in the business community are advocating for Medicaid expansion because of the estimated $53 billion in federal funding it would bring to Florida over the next decade.
Still, Sebelius held out hope on Tuesday that Florida legislators may still accept the federal government’s open-ended offer to pay for 100 percent of the cost to expand Medicaid for 2014, 2015 and 2016, and never less than 90 percent after that.
“There’s still an active and ongoing and very important discussion here in Florida about Medicaid expansion,’’ she said.
But Florida has been particularly inhospitable to federal healthcare reform.
Led by Gov. Rick Scott and the GOP-dominated Legislature, Republicans have questioned the security of the new Obamacare system, refused to help set up a state-based insurance exchange or expand Medicaid under the law, tried to block healthcare-outreach “navigators’’ from county health departments, and stripped the state insurance commissioner’s authority to negotiate or refuse rates for plans on the new online exchanges for 2014 and 2015.
Sebelius called this last act particularly reckless, emphasizing that Florida is the only state in the union to remove rate review authority from its insurance commissioner.
“The only people disadvantaged by not having rate review in Florida are the millions of consumers who now don’t have the office looking out for them,’’ she said.
Herald Staff Writer Marc Caputo contributed to this report.