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The perils of Florida’s refusal to expand Medicaid

Charlene Dill is one of an estimated 2,000 people who expected to face dire health issues due to lack of access to care

Photo: , License: N/A

Photo: , License: N/A

DCF actually handles the eligibility side of the Medicaid conundrum in Florida, while the Agency for Health Care Administration handles the distribution of benefits. D’Aiuto, in typical administrative fashion, has no real opinion on the prospect of expanding the Medicaid plan and can only speculate as to whether the state office discussed what costs that might bring to the agency (currently suffering in public relations for various foster care travesties). But the Medicaid eligibility issue is difficult to pin down, beyond the fact that, at least currently, only mothers with kids are welcome into the system.

According to the DCF website, parents are only eligible if their income is less than or equal to 19 percent of the Federal Poverty Level. The Federal Poverty Level for a household of four in 2014 is $23,850. Charlene Dill would have missed that mark if she made more than $4,531.50. Medicaid expansion would have raised that percentage of FPL to 138 percent, or $32,913, and would also have included non-parents in a household of just one that made less than $16,104.

Coincidentally, Kathleen Voss Woolrich found out she lost her Medicaid benefits on April 2 after driving all the way from Conway to Kissimmee to see a doctor that would accept Medicaid – again, on a day off from canvassing for the ACA. She was bumped into the “Share of Cost” program via DCF.

The program operates with a deductible of sorts – you are given a monthly share-of-cost dollar figure that’s tabulated based on your income. If your medical needs for the month meet or exceed that figure, Medicaid then kicks in and pays the bill. If not, you pay your own bills. From the website: “Your share of cost is $800. You go to the hospital on May 10 and send us the bill for $1,000. You have met the share of cost and are Medicaid eligible from May 10 through May 31. Medicaid will pay the $1,000 medical bill. This is only an example.”

D’Aiuto gives a similar example and says that there is no reimbursement should you accidentally pay your bill. And in order for Medicaid benefits to kick in, you have to spend a lot of money (or at least owe a lot of money) before you have any coverage at all. Woolrich says her doctor – who charged her for her visit and gave her the required prescriptions for the autoimmune disorder for which she is often hospitalized; prescriptions she couldn’t afford to fill until she met her $491 share of cost – asked, “Why don’t you just go to the emergency room?”

Which is exactly why people like the SEIU’s Monica Russo, along with most medical-care associations and interests who are busy covering the unpaid hospital costs of the indigent and poor, are adamant about pursuing expansion for the Medicaid program. Health and Human Services Secretary Kathleen Sebelius has made it clear to the Legislature and the governor that there is still time to opt in, should they be so compelled. And, in an election year, they just might.

“Going into election season, basically we have the spirit and the memory and the mantra of Charlene Dill. We need to make sure that there are no more Charlene Dills that are victims of this system,” Russo says. “That’s our mandate. Charlene Dill goes on. Make sure that her legacy is alive.”

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