Medicaid in Florida

Medicaid and Florida Kid Care are an important part of the benefits you may be eligible for in our great state. The goal is to ensure that no citizen goes hungry or is unable to receive medical care. At James Insurance, we will provide you with information and enrollment assistance even though we receive no compensation for that service. My goal is to treat every client as my most important.

Florida, however, elected to NOT expand their Medicaid program. Unfortunately, this left a significant number of individuals in the “black hole”-meaning, they are unable to qualify for Medicaid and make too little to qualify for the ACA subsidies.

The ACA envisioned people below 138% of poverty receiving Medicaid and thus does not provide premium tax credits for the lowest income. As a result, individuals below poverty are not eligible for Marketplace tax credits, even if Medicaid coverage is not available to them. Individuals with incomes above 100% of poverty in states that do not expand may be eligible to purchase subsidized coverage through the Marketplaces; however, only about a third of uninsured adults (3 million people) who could have been eligible for Medicaid if their state expanded fall into this income range. Thus, there will be a large gap in coverage for adults in states that do not expand Medicaid (Figure 3).

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Nationally, nearly five million poor uninsured adults will fall into the “coverage gap” that results from state decisions not to expand Medicaid, meaning their income is above current Medicaid eligibility but below the lower limit for Marketplace premium tax credits. These individuals would have been newly-eligible for Medicaid had their state chosen to expand coverage. More than a fifth of people in the coverage gap reside in Texas, which has both a large uninsured population and very limited Medicaid eligibility (Figure 4). Sixteen percent live in our state of Florida, nine percent in Georgia, seven percent live in North Carolina, and six percent live in Pennsylvania.

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