Health Care

Study: Working poor, undocumented immigrants remain uninsured in Florida

A man dressed as the Statue of Liberty advertises for an Affordable Care Act enrollment center on a Little Havana sidewalk in early 2015. Despite coverage gains under the health law, many Floridians remain uninsured, according to an analysis by the Kaiser Family Foundation.
A man dressed as the Statue of Liberty advertises for an Affordable Care Act enrollment center on a Little Havana sidewalk in early 2015. Despite coverage gains under the health law, many Floridians remain uninsured, according to an analysis by the Kaiser Family Foundation. MIAMI HERALD STAFF

More than a million Floridians had no health insurance in early 2015 because they were unaware they were eligible for new coverage under the Affordable Care Act, according to an analysis released Tuesday by the nonprofit Kaiser Family Foundation.

An additional one million Floridians were ineligible for financial aid under the health law because they earned too much to qualify for assistance, or they had offers of insurance from an employer, or they were undocumented immigrants, according to the Kaiser study.

In total, the study found, about 2.78 million Floridians lacked coverage in early 2015 — including about 567,000 adults who would qualify for Medicaid if the state were to expand eligibility for the public health insurance program for low-income people. The Legislature has opposed Medicaid expansion.

Rachel Garfield, a senior researcher for Kaiser and lead author of the analysis, said the data shows there are still a lot of people in Florida and the nation who remain uninsured despite coverage gains made under the health law.

Perhaps more importantly, she said, the data reveals that many people will not gain coverage under the law but will continue to require healthcare services.

“The numbers are helpful in continuing to shine a light on those who remain outside the reach of the Affordable Care Act,” she said, “and helping policymakers think about solutions for addressing their health coverage and their health needs.”

Among the uninsured Floridians identified by Kaiser in early 2015 were an estimated 384,000 undocumented immigrants, and an additional 417,000 people who had insurance available from an employer but remained uninsured because of a so-called “family coverage glitch.”

The health law defines affordability — and calculates eligibility for financial aid — based on the cost of individual, rather than family coverage. So some working people cannot afford employer-sponsored insurance for both themselves and their families, nor do they qualify for subsidies to lower their costs.

For example, some employers offer health insurance coverage to their workers at little or no monthly premium for the individual. But the cost for those workers to cover their families can be more than 9.5 percent of annual income — the threshold for defining “affordability” under the health law.

While a fix for the family coverage glitch would require an act of Congress, state legislators are in a position to help another group of Floridians gain health insurance: those in the Medicaid coverage gap.

The health law allows states to expand eligibility for Medicaid to nearly all non-elderly adults with incomes at or below 138 percent of the federal poverty level, or about $27,724 for a family of three in 2015.

But Florida is among a group of 20 mostly Republican-led states that have opposed Medicaid expansion.

Currently, Florida restricts Medicaid eligibility to certain categories of low-income people, including children, pregnant women, and parents with dependent children whose household incomes are below 30 percent of the federal poverty level, or about $6,027 for a family of three.

Open enrollment for health plans sold on the ACA’s insurance exchange begins Nov. 1 and runs through January.

Daniel Chang: 305-376-2012, @dchangmiami

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