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Too Young for Medicare, Too Old for Medicaid, and Neglected By Affordable Health Act

| October 30, 2013

star-bocsi-health-care

While most of the uninsured will be able to get subsidized health coverage Jan. 1 under the Affordable Care Act, the poorest adults under 65 will be out of luck in many states, including Florida.

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You could call them “The Forgotten.”  Many are women in their 50s and 60s, too old to have children still at home so they can’t qualify for Medicaid. But they’re not yet 65 so they don’t qualify for Medicare, either.

One of them is Debra Straley, 56. She has no job and no health insurance, but luckily can get her high blood pressure pills at the St. Petersburg Free Clinic.

She worked as a waitress at a pancake house until she got laid off nine years ago, she said. Unemployment ran out after two years. Since then, she has made ends meet with food stamps, renting out rooms and odd jobs.

Always, Straley says, she’s looking for permanent work. But it’s hard to make a good impression when you’re toothless. She can’t afford false teeth.

“I would do anything — waitress jobs, taking care of people, cleaning jobs — but there’s nothing out there. I’ve applied all over at restaurants. McDonald’s, Burger King. But they want young kids, you know that. I’ve applied to take care of people, but every time you see an ad in the paper, there’s like 50-60 people applying for the job.”

Straley is one of 5.2 million uninsured Americans, including more than 760,000 in Florida, who will be shut out of subsidized health plans come Jan. 1, according to a recent report from the Kaiser Family Foundation. They will be too poor to qualify for subsidies on the Health Insurance Marketplace.

This “coverage gap” arose from the Supreme Court’s 2012 decision upholding the Affordable Care Act but allowing states to opt out of Medicaid expansion, which was supposed to cover people below the poverty level. Florida opted out.

That means subsidies will be available to those between 100 and 400 percent of the poverty level, but not to those below. The result: Floridians who earn $20,000 or $30,000 or even $40,000 qualify for subsidized health plans, while those who earn less than $11,500 don’t.

That includes Priscilla Daniels, 52. She was a housekeeper for 30 years but had to quit work when her bronchitis and asthma got so bad she has to carry around a machine to help her breathe.

“I get so tired,” Daniels said, in a fading voice. “So tired.”

She applied for Social Security Disability but was denied, so she’s living with her sister.

Straley and Daniels, who come from a blue-collar background, are typical of the forgotten. But Star Bocsi is not.

An immigration lawyer in solo practice, Bocsi loves what she does but makes a modest income, since many of her clients have little money.

“The rates I charge are pretty low and I do a lot of pro bono work and extra work,” she said.

She could earn more in a different field of law, but she loves what she does, saving people from being deported and separated from their family.

“It’s the best thing in life,” she said.


During the recession, as her clients struggled, she did, too. She didn’t buy health insurance, even though she was 52, because money was tight and she figured she was healthy. But in March, she and her husband, a student who works part-time, were in a car accident with a hit-and-run driver. She had surgery on her shoulder and has been in physical therapy four days a week ever since, trying to regain use of her arm.

The medical and hospital bills piled up. Calls from creditors began. Bocsi says her personal injury protection auto insurance should cover at least part of it, but the company seems in no hurry to pay.

When she read about the Affordable Care Act and the Health Insurance Marketplace and the subsidies, she got excited.

“I thought this was it, okay, they did something. They made this new law, it’s going to change, it’s going to get better, it’ll be affordable. That’s what I thought.”

But then she noticed the part that said those under the poverty level didn’t qualify. After covering the overhead for her law practice, she says, she actually lost money last year. With all the lost income from her injuries, she’s likely to fall below the poverty level again this year, she said.

Bocsi, Daniels and Straley may come from different backgrounds, but they’ve ended up in the same place: uninsured and forgotten, at least in terms of health reform. Bocsi can declaim at some length on the unfairness of that.

“Everybody should have health care,” she said.

It’s not too late for Florida to change its mind and accept the money to cover the forgotten uninsured, as federal officials recently noted.  A number of Florida groups — the League of Women Voters, the Chamber of Commerce, and hospitals — say they will try to persuade the Florida House to change its attitude and take the money.

–Carol Gentry, Health News Florida

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18 Responses for “Too Young for Medicare, Too Old for Medicaid, and Neglected By Affordable Health Act”

  1. Sandy Peterson says:

    Well we can thank good old REPUBLICAN Gov. Scott for this. It’s unconscionable that the poor can’t get help through the affordable care act. That Florida will not expand Medicaid. I’d like one GOOD reason why not. Why do taxpayers have to keep footing the bill for those emergency room visits. It makes no sense when the federal government will give money to the state to expand Medicaid and the state doesn’t take it. It’s ridiculous. But let the idiots out there keep voting for these Republican fools that are sabotaging our country’s growth. Makes me sick. Vote these idiots out!!!!!

  2. Sherry Epley says:

    This situation is all thanks to our state legislators who refused to allow for the Medicaid expansion in Florida. They all need to be voted OUT!

    • Genie says:

      @ Sherry Epley: It’s not that I disagree with you, Sherry, but who is going to pay for it? Seriously. Palm Coast owes the state plenty on Medicaid already. We can’t pay our bills, so who is going to pay for it?

      More rich people?

  3. Ben Dover says:

    I had my neck destroyed at Sea Ray Boats due to a faulty rack, and a QC who had no business trying to lift the 400 lb window into it with me at his age, of course they own all local lawyers , so after 8 months out , I came back went to 5 years of school to become Parts and Accessories Coordinator, then Craig Wall 2nd in charge at facilty got into big fight with my father in law , father in law quit , so Mr Wall came after me , threw me out of my job I went to school for back onto dock where he knew I couldn t do all that heavy lifting due to my neck injury sustained there, but I did it for a lot longer then he thought I could , I just bought a house I had to, , then one of their 40 yr old broken down forklifts ran over my foot,I told them there was no room left on dock to unload truck, was told to continue or be fired , after the forklift severed my ligament in foot when it popped out of gear like it was prone to do and emergency brake was broke, two weeks later I had to paint lines on dock make rows for three lines of skids when that wasfull we could no longer unload trucks , kinda shutting the gate after the horse got out, didn t bother trying to sue again they have all local lawyers in their pocket, before my injuries there I also did landscaping and tree work on weekends, Mr Wall made up bogus marks against me to have me fired , no verbal , no written , just you have 10 marks your fired, now I cant work , I tried but tore my rotator cuff that company FIS fired me too , so I keep getting denied by ss disability , the 26 thousand extra I paid Prudential insurance for 9 yrs after my first injury at Sea Ray they just kept denying my long term disability , now I can t work , Gov Scott made sure Medicaid wasn t extended in Florida, so I am totally not in any way shape or form being helped by the ACA, Ive sold everything I have to get to Dr appts, and now the FDA just made getting the last drug availible to make my life bearable almost impossible to get , this state is going to force me to commit suicide

  4. Raul Troche says:

    Obama care? Nobama care. It’s another screwed up scam to make some rich men richer and some poor men poorer

    • Anonymous says:

      Raul the only reason Obamacare is not working is because Greedy republicans have been fighting it all the way , they made the chances in the law for racist Rep Gov in 29 states not allow it in there states, it takes away bribe money thieving they`ve been getting from insurance and drug companies for yrs,just the erasure of the pre existing condition loophole has cost them bribe taking thieves millions, why do you think they held the country hostage , shutting down the gov , they walked away with 2.8 billion bucks and if you really believe that money is going to build a dam in Kentucky , then Ive got a bridge in NY you can buy dirt cheap, Republicans are the war mongers and the ones who steel from the poor to give to the rich, Obama is trying to get healthcare to babies born with horrible deceases, people stricken with cancer, or people like myself injured on the job and screwed by their greedy companies, like all insurance plans the more people enrolled the cheaper the rates if the 29 states with Rep Gov joined in, stopped trying to appeal it 41 times after it was already a law, stopped hiring hackers to sabotage the site , it would give eveyone in this country much cheaper and better health care , DON~T BLAME OBAMA IT`S BOEHNER AND THE TEA PARTY GREEDY SLUGS!!!!

  5. Had Enough says:

    Way to go Obama…..Create a ” flim flam” health insurance scheme which does not even HELP the really POOR and NEEDY. Regardless if Florida excepts more money from the government for medicare, its still going to put this nation in a deeper DEBT then ever in the history of the United States…….Its all a scam so politicians keep their HUGE salaries and PERKS, and the rest of America DIES ! Its KILL or BE KILLED in America now. Everyone out for themselves and SCREW your neighbor or your relatives. Its really time for a population CLEANSING .

    • A.S.F. says:

      @Had Enough says–A “population cleansing?/” By any chance, is that anything like “ethnic cleansing?” By the way, the “really poor” already qualify for Medicaid and they will not suddenly be abandoned because of the ACA. More people who didn’t qualify for that particular safety net before will receive financial help to secure health insurance coverage that they couldn’t get before. Some people will see their rates go up but they will also receive coverage for things not included in the “junk” policies that many of them have had to settle for before (no coverage for pre-existing conditions, prescriptions, hospitalizations, maternal care, mental health coverage, selected exclusions and lifetime limits on serious, even life-threatening, conditions ) What really concerns me is the way these changes are being rolled out. Obama and his team need to get on the ball and quick! I hate to say it, but Sebilius should resign because any further screw-ups under her leadership will only lead to a further lack of confidence among the public. I can’t understand how we could have been so stupid as to hire a Canadian company to oversee the website when that company had already been fired by Canada! Inexcusable! Anyone responsible for making such bad decisions, and anyone who may be involved with covering up information about problems that were already being flagged in the testing stage, should be gotten rid of immediately.

  6. Geezer says:

    NO AMERICAN SHOULD GO WITHOUT HEALTHCARE OR DENTAL CARE.

    One lady in the article lost all her teeth.
    Teeth are not just for cosmetics….
    A jaw without teeth erodes over time
    and will fracture and deform.

    Let’s spend on our people and not so much
    around the globe. The American nation is its PEOPLE.
    Our most valuable resource!

    God bless the United States. It can sure use it now…..

  7. Sherry Epley says:

    This is not about President Obama! The Federal government offered $$$$ to fund the expansion of Medicaid as part of the Affordable Care Act (Obamacare) and the fascists in our legislature voted against accepting that money. This ridiculous situation was caused solely by the idiots in the Florida legislature. . . who need to be voted OUT!

  8. dogman says:

    Florida will be a democratic state soon thank god
    the republicans are going to be a dying breed
    by scott… by rubio and all you other loosers……..

  9. nomad says:

    Florida did not sign on for this scheme because, in addition to it being a scam that will eventually become a huge burden to the Florida taxpayers, it will also attract those who will simply relocate to Florida for all the freebies. The main reason large corporations have not relocated their businesses to Florida has to do with the lack of a qualified talent pool and the constant rebuilding as a result of hurricanes. Also, relocation expenses are not cheap for companies – take it from someone speaking from experience.

    So, if Florida’s aim is to attract corporations dependent on highly skilled employees – aka high income earners, it cannot allow itself to be the state of the overwhelming poor, desperate poor, and retired, to boot. Florida is already one of the most affordable states to live. Should Florida become more generous in its attractiveness to the poor it will likely end up up worst off than the poorest of countries. The northern states already dump its mentally ill on the borders of Florida, and Florida already has its fair share of northerners who do not know the difference between a pig sty and clean living environment. Let’s face it, Florida’s economy is now mostly dependent on tourism. And no tourist wants to spend their dollars visiting a poor and decrepit state/location.

    Sorry to have to be the voice of reality…

    • A.S.F. says:

      @nomad says–Sorry to be the “voice of reality” in return but Florida is already pretty close to being the state of the overwhelmingly poor, desperate poor and retired because of political policies already in place. Maybe those inferior beings don’t happen to live in your neighborhood (lucky you, I guess)…Either that, or you are very practiced at turning your eyes away so that you cannot see them. However rich you may be in other ways, you could use some shoring up in the area of compassion.

    • Geezer says:

      “it will also attract those who will simply relocate to Florida for all the freebies”

      Boy, you live a sheltered life. What freebies are those?

  10. BW says:

    The reality is that the Affordable Care Act is not the solution. We are actually in the same boat in our household. It’s the middle-class that gets screwed on this. Devising a plan that forcibly and blatantly takes from one to give to another with no motivation for the one receiving to ever provide for themselves is not a solution. President Obama himself in his book “Audacity of Hope” speaks directly against giving without solving the issue of why they need in the first place. Yet his plan is the exact opposite. Costs of healthcare rising is the problem, and this is not the solution. You will drain those that can give more and more and until there is no more to give.

    And it’s not a rich not giving problem. They are, but the ones really getting squeezed are the middle class. And, no, I am not a Republican. And, yes, the Affordable Healthcare Act needs to be repealed.

  11. Genie says:

    It seems to me that Star Bosci must have made the decision NOT to have healthcare because immigration attorneys charge approximately $2500 at a minimum for services which are available for free from their elected federal officials offices.

    Compassion, ASF? Do you really think you are the only one who feels compassion?

    Gov. Scott sees the reality, that there is not enough state money to pay for these programs when the federal money runs out. Congress doesn’t, or doesn’t care. Talk to them about compassion.

    The rest of us struggle to pay our bills, waiting for the day when the cupboard is bare. And that day is coming sooner for many, rather than later under this new law.

    • A.S.F. says:

      @Genie says–Governor Scott and his crew have turned away federal money that some people in desperate need in Florida badly need because they are interested in winning points with their Tea Party constituency. You know, the people with their Obama-Hitler-mustache signs, their red, white and blue bumper stickers and their pointy little hats? Governor Scott was the one who wanted to crush Healthcare Navigators having the ability to help people make sense of the new ACA intitiative, just so he could put one more roadblock in the way to help it fail.I certainly do not hold a corner on Compassion. But icompassion seems to be a muscle that some Conservatives have let atrophy in their quest for MORE MORE MORE FOR ME ME ME. It is not necessarily the case that helping people always comes at the cost of making others poor. That is an excuse to service your prejudices and desires at an obscene cost to others that you fear, resent or look down on. Governor Scott sees reality, alright–The reality of his own interests, And as long as the interests of others don’t get in the way, that’s fine. If they do, too bad…He’ll just whip up the paranoia and egocentricity of his neo-conservative base to do his dirty work for him. Good luck to you, Genie, if you really believe he is on your side (or anyone’s other than his own and those of his cronies.)

      • Genie says:

        @ ASF, are you referring to the same healthcare navigators which Sebilius testified today “may be convicted felons?”

        I trust the people who stand with the Constitution more than I trust this administration. You are, however, entitled to your opinions.

        I am watching middle class people now having their policies cancelled and they are unable to afford the replacements because they make too much money. Do you have a referral for them?

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