Barely Getting By [Extra]

Despite record low unemployment and wage growth in recent years, Floridians continue to grapple with skyrocketing housing and insurance costs, inflation on food and other consumer goods and, for those with children, an acute childcare shortage exacerbated by surging costs for when families can find it. One in three Florida families – nearly 2.7 million households led by working Floridians – who are above the poverty level are struggling to make ends meet. In the January 2024 issue of FLORIDA TREND, we asked what the Florida Legislature — which begins its regular session on January 9 — could do to help them through housing policy, the state budget and sales tax policies.

The United Way has taken the lead in focusing attention on working families who earn above the federal poverty line and largely do not qualify for government assistance. The organization refers to those families as ALICE: Asset Limited, Income Constrained, Employed; and they exist in large number is nearly every community. ALICE families are those led by teachers, first-responders, civil servants, nurses and even attorneys working in Florida’s public agencies, like public defenders’ offices. United Way data puts ALICE families at above the federal poverty level of $26,500 to $66,324 for a family of four.

To learn more about the scope of Florida’s economically-fragile working families, including a county-by-county breakdown of the numbers, visit https://www.unitedforalice.org/state-overview/florida.

Throughout the 60-day legislative session, we’ll post updates on how Florida lawmakers are addressing the concerns of families who make up the broad base of the state’s economy here.

HEALTH: Expanding Health Care Access

Last year, Florida legislators did one big thing for ALICE families’ health care: They increased the number of children covered under Florida KidCare, the state’s subsidized health insurance program for kids.

Previously, only families earning 200% of the federal poverty level qualified for KidCare coverage. Beginning this month, families earning 300% of the poverty level will qualify. That way, families won’t fall off what’s called the “financial benefits cliff” and lose their coverage if a parent accepts a 50-cent raise at work.

This was a priority for House Speaker Paul Renner. Lawmakers who sponsored the bill emphasized that it was intended to help working people. “That’s going to make a big difference,” says United Way of Florida CEO Melissa Nelson. “When you have to choose between proper medical care for your child, or a quarter or 50-cent raise, ultimately you’re going to choose for your child.”

This year, Democrats and advocates for the working poor will tell you that the best thing the Legislature could do for their health care would be to expand Medicaid coverage to more people using a mix of federal and state dollars, the way 41 other states have. That would help close the so-called

“coverage gap” for those who earn too much to qualify for Medicaid but not enough to afford private insurance.

However, that’s not going to happen in Florida, with the state’s political leadership lined up against the idea. Gov. Ron DeSantis, Senate President Kathleen Passidomo and Renner are all opposed to it. “We’re not going to be like California and have a massive number of people on government programs without work requirements,” DeSantis said during a GOP primary debate in September.

The Legislature has other priorities in mind, and both Passidomo and Renner say health care will be a priority this year. Renner created a Select Committee on Health Innovation for the 2024 session. Passidomo, who championed last year’s Live Local Act, is sponsoring what she calls the Live Healthy Act to try to expand access to health care.

Sen. Colleen Burton (R-Lakeland) is chair of the Senate Health Policy Committee and has been tapped to lead the Live Healthy initiative. Lawmakers will focus on growing Florida’s healthcare workforce using a variety of methods such as tuition reimbursement and increased residency positions at Florida hospitals; and removing regulations that prevent health care practitioners in other states from moving here to work.

“The exponential growth in our population and our aging population puts a real strain on our health care system,” Burton said. “This is really about access for everybody in Florida, across the socioeconomic spectrum of Floridians. We have a growing access issue, and we’re trying to get out in front of it.”

Meanwhile, the Florida Hospital Association and the Florida Medical Association are advocating for many of the same things because they’re also concerned about a shortage of health care professionals. They also want to raise what they describe as nationally low Medicaid physician reimbursement rates for procedures including delivering babies, which they say will help hospitals’ labor and delivery centers stay open.

Tags: Extra, ALICE in Florida