State legislators, along with community advocates, urged Senate Democrats and the Biden administration to close the abortion coverage gap for vulnerable Floridians at a press conference hosted by Health Care for Florida on Tuesday. The calls to action follow the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, effectively overturning federal abortion protections.
Approximately 425,000 Floridians fall into the Medicaid coverage gap, according to data from the Center on Budget and Policy Priorities. These individuals have income too low to qualify for marketplace assistance, but too high to qualify for Medicaid, since Florida has not expanded its low income eligibility cap.
Advocates are concerned the overturning of federal abortion protections, combined with Florida’s lack of Medicaid expansion, is creating a coverage gap that will disproportionately impact communities of color and increase maternal mortality rates.
“Dobbs will worsen physical and behavioral health and unconscionably high rates of Black and Indigenous maternal and infant mortality,” said Florida State Rep. Angie Nixon (D-Duval) at the press conference. “This decision means that people in states that haven’t adopted the Affordable Care Act Medicaid expansion—like Florida—need access to health coverage now more than ever.
Black women and birthing people already have disproportionately high rates of maternal mortality. The pandemic has only deepened these inequities and maternal deaths increased nationwide at a higher rate for Black and Hispanic women and birthing people. Losing access to legal abortions is likely to mean higher maternal morbidity and mortality rates, driving up health disparities. Non-expansion states like Florida are moving to restrict legal abortions the most. Pregnancy can be a death sentence for some women, particularly Black women, who are 4 times greater risk of experiencing maternal mortality.”
Of the 425,000 Floridians currently in the coverage gap, about 170,000 are women of reproductive age, according to Florida Policy Institute Chief Strategy and Development Officer Holly Bullard. While Florida has followed other states in recently expanding postpartum Medicaid coverage to 12 months, Bullard argued the state should provide more comprehensive reproductive care.
“You definitely need health care running up to a healthy pregnancy in order to address things like diabetes and long term health issues,” she said. “Those are all contributors to our maternal health crisis.”
One solution to closing the coverage gap could be through the budget reconciliation process, according to Scott Darius, Executive Director of Florida Voices for Health. With 50 Democratic and 2 Independent senators in consensus, Congress can allocate funding to close the coverage gap.
“The reason we think there’s such an opportunity now is because using the budget reconciliation process, the Senate only needs 50 votes to get this thing done,” Darius said. “… As they contemplate what the next budget reconciliation bill will look like, this is something that we know they can incorporate into that policy solution, and we could get it done without necessarily needing to pull in Republicans.”
In April 2022, the Biden administration released a statement that vowed to expand health care coverage for families. This included a proposed rule to address the “family glitch,” which can deny low-income family members from receiving ACA premium subsidies. However, ambiguity remains on whether implementing laws through the budget reconciliation process sidesteps Congress.
Still, Florida advocates continue to push for federal action.
“Senate Democrats and the Biden administration have been vocal about the need to address structural health inequities for Black moms, have decried institutional racism, and most recently, pressed for action to protect women’s health in light of an extremist Supreme Court overturning Roe v. Wade,” Nixon said at the press conference. “Well, here’s your chance. Here’s your chance to prove that when you say you’re standing up for women, for people of color, it’s not just talk.”