Florida has the nation’s second-highest rate of uninsured residents younger than 65 — a total of about 3.8 million people, or about 25 percent of the state’s population, including more than 500,000 younger than 19, according to U.S. Census data released Thursday.
And out of all 67 counties in Florida, Miami-Dade has the second-highest rate of uninsured for the same age group at 34.4 percent, trailing only Hendry County, with an uninsured rate of 35 percent or about 11,500 residents. Miami-Dade also is home to the largest number of residents without health insurance in the state younger than 65 — an estimated 744,000 people.
Broward County’s uninsured rate is 26 percent, or about 392,000 people.
Steven Marcus, chief executive of the Health Foundation of South Florida, a public charity that funds healthcare initiatives in the region, attributed Miami-Dade’s high rate of uninsured residents to the county’s large number of small businesses, many of which do not offer health insurance to their employees — the most common method for Americans to receive coverage.
“We’re a very small-business, service economy,’’ Marcus said. “Our small businesses have never supported healthcare.’’
A large number of undocumented workers also live in Miami-Dade; it’s unclear if the census data included that population, which does not qualify for government-sponsored insurance programs.
The census data, referred to as Small Area Health Insurance Estimates, reflects county-level and state-level information as of 2011, the most recent year for which information is available.
Americans 65 and older qualify for Medicare, the federal healthcare program for the elderly. For the poor and disabled younger than 65, Medicaid may offer coverage.
Expansion of Medicaid, a joint state and federal health insurance program, was a keystone of President Barack Obama’s healthcare law and took center stage during Florida’s legislative session this year. The Senate supported a bipartisan plan to accept federal money to let Floridians obtain insurance through a state-subsidized system. House Republicans insisted on an alternative plan to use $300 million in state money to buy basic coverage for 130,000 low-income Floridians.
The two sides were unable to strike a deal — and passed on an estimated $50 billion in federal funds over the next 10 years.
In response to the latest census data, House Democratic Leader Perry ThurstonD-Fort Lauderdale, issued a statement Thursday calling Republican legislative leaders’ refusal to accept the federal aid “inexcusable and shameful.”
Thurston said Medicaid expansion would have provided coverage to more than a million low-income Floridians: “The Legislature’s failure to expand health coverage continues to punish working families and small businesses throughout Florida.”
Jackie Schutz, a spokeswoman for Gov. Rick Scott, a Republican, said the governor’s stance on Medicaid hasn’t changed. “During the session, he said yes and the Legislature said no,” she said, referring to the governor’s preference for a Senate proposal to accept federal funds to provide insurance to Floridians below 138 percent of the poverty level — $15,865 for an individual and $32,499 for a family of four in 2013.
Federal healthcare reform provides tax subsidies for those earning between 138 and 400 percent of the poverty level to buy health insurance through online exchanges scheduled to debut Oct. 1.
No Special Session
Schutz reiterated Scott’s position that he will not call a special legislative session to reconsider Medicaid expansion.
Florida House Speaker Will Weatherford, R-Wesley Chapel, who led the charge against Medicaid expansion, also issued a statement Thursday acknowledging the troubling data, but defending the Legislature’s actions to help the uninsured.
“This year, the Florida House did not just say no to Medicaid expansion. We offered a free-market solution that strengthens our safety net and will provide more than 525,000 uninsured Floridians with private health insurance, not Medicaid. We should continue seeking solutions that allow Floridians access to quality healthcare, not government-run healthcare.”
Florida is not the only state to turn down the federal government’s offer to pay 100 percent of the cost of expanding Medicaid. (In Florida, that would amount to an estimated $5 billion a year, from 2014 through 2016, and at least 90 percent thereafter.)
According to the Kaiser Family Foundation, a California-based nonprofit, as of this week 16 states have signed into law legislation authorizing Medicaid expansion, while four — North Carolina, Texas, Utah and Wyoming — have passed legislation prohibiting Medicaid expansion without legislative approval. (Kaiser Health News is an editorially independent program of the foundation.)
Three states — New Hampshire, South Dakota and Virginia — have established committees to further study Medicaid expansion.
The other states either ended legislative sessions with no legislation authorizing Medicaid expansion, such as Florida, or their legislatures and governors are still debating expansion.
Maine is the only state whose governor vetoed legislation authorizing Medicaid expansion, according to the Kaiser data.
There is no deadline for Florida to accept the federal dollars, and state lawmakers could choose to opt out at any time after expanding Medicaid.
But the longer Florida lawmakers wait to accept the funds, the more they will lose when the clock starts ticking on Jan. 1.