Nearly 40 years ago I gave birth while covered by Medicaid, which provided coverage that lasted 60 days postpartum. After that, I lost coverage and spent years without health insurance. I mainly received care priced on a sliding scale at a local federally qualified health center.
After President Barack Obama signed the Affordable Care Act (ACA), I was able to purchase affordable health insurance on the health care exchange. The ACA covered all the health care I needed including my asthma prescription. But although the ACA worked for me, many others fell through the cracks — including people who didn’t have enough income or had too much income to qualify for premium tax credits.
In states where the ACA is fully implemented, some of these people are covered by expanded Medicaid. But here in Florida, the Legislature has refused for over 10 years to implement the ACA’s Medicaid provisions, leaving over 425,000 people without coverage or access to prescription medicines. I once had to share an inhaler with a friend, who lacked insurance and couldn’t afford the cost of an inhaler.
The price of asthma inhalers increased significantly in the last decade even for people with insurance. Those who don’t have any coverage often can’t get a prescription for the medicine they need and if they are able to get a prescription, can’t actually afford the medicine. One in three people with prescriptions skip doses or forgo medicine because of the price.
President Biden is moving in the right direction. In March, he signed the American Rescue Plan Act (ARPA) which provides increased funds for health centers, like the one where I got care when I was uninsured. ARPA made ACA coverage more affordable by increasing the premium tax credits to buy coverage for people across all incomes. The new law saves an average 60-year-old Floridian over $500 a month for a mid-level policy, for instance.
ARPA also helped states like Florida to increase Medicaid coverage for some people — like new moms. Florida’s Legislature just increased postpartum coverage from 60 days to a full year thanks to ARPA. Unfortunately, Florida lawmakers did not take up the extra funding in the federal package for Medicaid expansion so we still have hundreds of thousands without coverage.
The President and Congress must do much more this year to expand coverage and affordability. Biden’s current proposal, the American Families Plan, would make improved ACA affordability provisions in ARPA permanent — but it doesn’t include any plan to close the coverage gap for the millions who can’t get access to Medicaid because of political gridlock that has blocked Medicaid expansion in our state. It also doesn’t include any plan to lower the price of prescription drugs, even though the president has acknowledged that action is needed on this issue — which also impacts me.
In a couple of years I’ll be eligible for Medicare, but Medicare Part D doesn’t guarantee affordable prescriptions. Millions of seniors in Part D can’t afford prescriptions because negotiations to lower prices are prohibited by law and there is no out of pocket cap on what seniors pay. Congress can fix the problem by passing H.R. 3, the Lower Drug Costs Now Act to lower prices, cap costs and ensure that drug corporations don’t overcharge patients.
For years, Americans have been hearing lip service from both parties about health-care coverage and affordability. As the nation works hard to overcome the health and economic consequences of the pandemic, there’s never been a better time for action that will guarantee that every person has access to quality, affordable coverage no matter where they get their coverage. It’s up to us to make sure every member of the Florida Congressional delegation supports proposals that make life better for Floridians and put our health ahead of their politics.
Sabrina Thomas, who lives in Kissimmee, has been involved with the Black Women’s Roundtable since 2010 and is the Co-Chair of the Osceola County chapter.