Expanding Medicaid: More Critical Than Ever for Older Floridians in the Time of Coronavirus
By Blanca Mesa and Miriam Harmatz
The COVID-19 pandemic has created fear among virtually all Floridians. And there's no group more justifiably afraid than low-income uninsured seniors. Seniors age 60 and up, who comprise over one-quarter of the state’s population, are particularly vulnerable to the virus, with more complications and higher death rates.
Things were already scary for these Floridians. Because we are one of only 14 states that has not expanded Medicaid under the Affordable Care Act, older uninsured Floridians not yet on Medicare have no way of affording healthcare.
Thomas Yarema’s story is illustrative of too many of Florida’s uninsured seniors. Like Thomas, few employees in our state’s tourism- and construction-based economy have healthcare benefits. Even those jobs that do offer healthcare benefits virtually never provide pension-based healthcare for individuals who lose their job, often because of an illness or injury they cannot afford to treat. COBRA and marketplace insurance are out of reach for low-income older individuals. Thus, in a state that refuses billions of dollars in federal funding per year to cover low-income uninsured adults under age 65, Floridians like Thomas must cobble together the limited treatment available for their ailments through community clinics. They try to hang on, hoping they don't get a potentially terminal illness before they turn 65, and qualify for Medicare. It would seem that Florida and the other 13 non-expansion states may be the only places on the planet where people who are already “older” want to age faster.
Mr. Yarema worked a series of hard labor jobs, from construction to managing warehouses, all his life. A self-described “workaholic,” he was devastated when he lost his job as a photographer, which required standing 12-14 hours a day, after his ankle gave out. He had no health insurance and had gone many years without annual check-ups. By the time he got help at a community health clinic, he suffered from untreated high blood pressure, thyroid disease and a host of other ailments. While some of his health conditions have been addressed, the issue with his ankle is unresolved. He remains unable to return to work, and fears he will lose the ability to walk in the future unless he gets appropriate care.
Having Medicaid would enable Thomas to get the surgery and treatment he needs to return to good health and return to work. Unfortunately, he has been forced to take early retirement at 62 just to get enough income from Social Security to pay for housing and food. As a result, he and his disabled wife will be spending their ”golden retirement years” living barely above the poverty level with less than $1200 per month. Now, he also has to worry about the fact that both he and his wife are at higher risk of complications and death if they were to contract COVID-19. And he faces this fear with no insurance or any way of paying for medical bills.
Like Thomas, tens of thousands of older Floridians have spent a lifetime of hard work in physically demanding jobs, including construction, landscaping, house cleaning, child care, home health care, and waitressing. And, because they have lacked healthcare coverage for years, many of these low-income, older Floridians suffer from ailments such as heart disease, diabetes, high blood pressure, and orthopedic issues that have left them unable to work or limited to part-time positions at low hourly wages.
Older Floridians who are uninsured and unemployed want to work! But they can’t get back to work without first getting needed health care. Medicaid expansion would enable roughly 150,000 hard-working older Floridians to not only get the treatment they may need for COVID-19, but also to address the underlying health conditions that put them at higher risk for complications and death from the virus in the first place.
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