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Health Care
00000173-d94c-dc06-a17f-ddddb4b10000By Wilson Sayre and Daniel ChangThousands of South Floridians too poor to afford health insurance on their own end up in what is called the "coverage gap." They earn too little to get help buying health insurance under Obamacare, but they don’t qualify for Medicaid.WLRN and the Miami Herald look at what life is like in the coverage gap through the experience of Miami resident Cynthia Louis. Reporters explore how being uninsured affects your life, your health, and your wallet.Need to find low-cost care? The Miami Herald developed a low-cost health care finder. Find help at hrld.us/findcare.

What It's Like To Be In The Health Coverage Gap In Florida

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Walter Michot
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Miami Herald

This is the first part in our series, Falling Into The Gap, in collaboration with the Miami Herald. Read more about the coverage gap and find affordable care on WLRN.org/healthgap.

The Affordable Care Act was originally supposed to cover a lot more people in Florida than it has. When Florida chose not to expand Medicaid, about 850,000 people were left without insurance.

Miami resident Cynthia Louis is one of the thousands in this health care limbo called the “coverage gap,” where they don’t get Medicaid and they don't qualify for subsidies to afford insurance.

Louis, 57, worked for Burger King for most of her adult life. Her last three years with the company were at a Burger King in Miami Shores.

“I worked for Burger King 25 years and loved every day of it,” Louis said, “just coming, you know, not just because of the money, but just the people and working, you know working.”

A year and a half ago, she started to feel sick at work. After sitting down for a while, she tried to stand up, but her knees hurt too much.

She left early that day and hasn’t been able to go back to work since.

“They miss me. I miss them, you know. I just hope and pray if I can come back here when I get well, I’ll be glad to come back,” Louis said.

Louis’ joints still hurt all the time. She used to have health insurance with Burger King, but after a while, she decided not to re-enroll because it was too expensive for what she was getting.

Now, she needed insurance. But because she has no income, she couldn’t get help from the government.

“Typically assistance programs start with people earning less, getting more and as you get more income, you get less assistance,” said Miriam Harmatz, a health law attorney at Florida Legal Services, “and you've got this shocking anomaly where the poorest people get nothing.”

South Floridians In The Gap

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Credit Kara Dapena / Miami Herald
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Miami Herald

Medicaid is health insurance for the “worthy poor” - parents with dependent children, pregnant women and the disabled.

In a family of four, the most the parents can make to qualify for Medicaid in Florida is just under $8,500. Single parent, one kid, making $6,000 a year? That’s too much to qualify for Medicaid.

In Louis' case, she is single with no dependent kids and not disabled. No matter how little you make, there is no Medicaid in this situation.

“So you mean to tell me, I done worked all my life, and I can’t get no Obamacare, no kind of insurance? Something wrong with that picture,” she said.

Not Expanding Medicaid

In Florida, really only part of Obamacare was ever rolled out.

Originally, the federal government would help pay for health insurance for people who made just above poverty level and up to four times that much.

For those who fell below that, they were supposed to get Medicaid. But that never happened because Florida is one of 22 states that has chosen not to expand its Medicaid program.

A year and a half after that day in Burger King when her joints started hurting, she still doesn’t know what’s wrong with her.

And really, she just wants to get better enough to go back to work.