Florida politics, a lack of awareness, and other forces are combining to prevent the Affordable Care Act from taking hold in Hendry County, which has the highest rate of uninsured in the state: 35 percent.
As Phil Galewitz of Kaiser Health News reports, "If any place in America needs help getting residents insurance coverage and a leg up on improving their health, this is it. "
More than one-fourth of the population in the county falls below the poverty level, which means they don't have access to the subsidies on the federal Marketplace. Thus, they can't afford to enroll. And state rules mean they won't qualify for Florida Medicaid unless they're pregnant, elderly or disabled.
Federal funds are available to Florida to cover those people in the gap through Medicaid or a private alternative. But the Florida House rejected attempts to accept the funds last year and appears ready to do so again.
Rep. Matt Hudson, a Republican who represents Hendry County in the Legislature, has been one of the most outspoken opponents of accepting the funding. He says: he doesn't trust the federal government to keep supplying the money; he thinks Medicaid and other health programs for the poor already take up too much of the state's budget; and he says doctors would be overwhelmed by the influx of new patients, crowding out the elderly and disabled.
Another factor is that the area attracts hundreds of immigrants, who are in the country illegally and aren't eligible for coverage under the federal law, Kaiser Health News reported.
Also, "Obamacare," as it is often called, continues to carry a stigma because of the negative news that followed the troubled rollout of the website, Healthcare.gov. Now the website is by most accounts working smoothly, but that positive news has not seeped into the collective consciousness.
Most people have heard only criticisms of the law, Karson Turner, chairman of the Hendry County Commission, told Kaiser Health News. "I am stunned by how few people are signing up," he said.