Our Patients Too Poor to Enroll: DOH

Sep 23, 2013

Floridians who use county health departments for primary care are mostly too poor to qualify for enrollment in a health plan through the online Marketplace to open Oct. 1, the Department of Health says.

Credit Florida Department of Health

So it makes more sense for “navigators” -- enrollment advisors for the uninsured who seek health coverage on the online Marketplace beginning Oct. 1 --  to go to other locations such as hospital emergency rooms, or county libraries, the memo says.

“Navigator services are for people who have money to pay for health insurance,” the fact sheet says. “Those are typically not (county health department) clients.”

Besides, the fact sheet says, two-thirds of Florida’s county health departments “no longer provide primary care services.”

The memo is only the latest press release sent to the media with the tag line “Setting the Record Straight.” DOH has been playing damage control for two weeks, ever since the agency ordered county health department directors not to allow navigators onto their premises.

Health News Florida was first to report the story on Sept. 11, but it quickly went viral and was covered by national news organizations. By last week, the media were describing Florida as  the state most determined to obstruct implementation of the Affordable Care Act, of which the  Marketplace is a key feature.

The fact sheet does not say why most uninsured people who seek primary care through the local health departments would not qualify for navigator services. The reason is that those who have family incomes under 100 percent of the federal poverty level will not gain coverage in Florida, because state lawmakers ruled out another key part of Obamacare -- expansion of Medicaid. That income level is about $11,500 for a single person and $23,500 for a family of four.

The DOH order led to friction between counties and the state, starting with Pinellas County. There, after the department director pointed out that the counties owned the buildings the state clinics were in, a compromise was achieved that allows navigators in the buildings but outside the DOH offices. 

But friction between DOH and the counties has continued to simmer. The Broward County Commission is set to pass a resolution Tuesday authorizing navigators and others to help with enrollment activities in the county-owned buildings where the Department of Health rents space. It’s essentially the same arrangement that Pinellas worked out.

“It is criminal that anyone would put their foot out to trip up that process for sharing information,” Broward Mayor Kristin Jacobs said in an interview with the Broward Bulldog. “You can’t tell us that we can’t do that in our own facility.”

Jacobs said she heard other counties voicing the same sentiment last week at a statewide meeting of the Florida Association of Counties.