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Florida health care advocates want Congress to close the coverage gap after the Roe v. Wade ruling

Thousands of people of childbearing age lack health insurance in Florida because they earn too much to get Medicaid and they don't qualify for Affordable Care Act subsidies.
Thousands of people of childbearing age lack health insurance in Florida because they earn too much to get Medicaid and they don't qualify for Affordable Care Act subsidies.

Congress has been meeting this week for the first time since the U.S. Supreme Court overturned Roe v. Wade, and health care advocates are urging lawmakers to spend the time closing the insurance coverage gap.

A coalition of groups including the Florida Policy Institute, Florida Voices for Health and MomsRising hosted a webinar on Tuesday to discuss the issue, which they say is especially important to address now because states that haven't expanded Medicaid are more likely to restrict access to reproductive health care.

About 425,000 Floridians live in the coverage gap, meaning they earn too much to qualify for the state's Medicaid program, but not enough to get premium tax credits on the Affordable Care Act Marketplace.

Many of these residents are people of color, who state Rep. Angie Nixon [D-Jacksonville] pointed out are more likely to have complications during pregnancy.

“Losing access to legal abortions is likely to mean higher maternal and mortality rates, driving up health disparities, and non-expansion states like Florida are moving to restrict legal abortions the most,” Nixon said.

It’s critical people have access to health care, advocates said, so those who don't want children can effectively prevent pregnancy and those who do can give birth safely.

Pregnant people can get on Medicaid in Florida more easily than other low-income adults, and the state is one of several around the nation that decided this year to extend postpartum coverage for a full year instead of 60 days.

But postpartum Medicaid coverage isn’t enough, argued Holly Bullard, chief strategy and development officer of Florida Policy Institute.

“People in the coverage gap often miss out on preconception and early prenatal care, because Medicaid pregnancy coverage doesn’t kick in until people know they’re pregnant and apply for Medicaid,” she explained. “Closing the Medicaid coverage gap in this upcoming reconciliation package would broaden access to women’s comprehensive coverage at a critical moment.”

Thousands of others could also benefit from filling the coverage gap, including Seminole County resident Allison Holmes. She is a full-time caregiver for her son who has disabilities and has struggled to access health care for years.

Holmes said she wishes Florida would expand Medicaid like 38 other states in the nation have, but leaders have repeatedly refused.

“In Florida you're on your own, and if there's a way out of this, I haven't found it,” she said before urging Congress to act.

Policy experts say one possible solution would be expanding eligibility for ACA subsidies for residents living in non-expansion states.

It’s unclear if Congress will include any policy changes in its next attempt at a spending package, which comes after the Build Back Better Act passed in the House last year but died in the Senate.

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Stephanie Colombini
Stephanie Colombini joined WUSF Public Media in December 2016 as Producer of Florida Matters,WUSF’s public affairs show. She’s also a reporter for WUSF’s Health News Florida project.