The Sunshine State is looking dark and ominous. The state that so values life that it outlaws abortions after six weeks of pregnancy has shelved the “sanctity of life” mantra for “save the dollar,” in this case the tax dollar. Forget “In God We Trust,’ the state’s motto. The good folks of Florida are trusting in Mammon.
Florida has acted boldly to assert its no-nonsense — Darwinian — approach to poor people. Instead of helping “the least of us,” the state is attacking them.
Consider Medicaid. Florida did expand Medicaid, the government-funded (state and federal) health insurance program designed for people who can’t grab onto an employer’s insurance, who are too young to sign onto Medicare, who are not part of the military — in short, who are potentially “uninsurable,” no matter how sick they are, how disabled, how much they might need medical help. Those seasonal low-paying jobs in agriculture and “service” industries rarely offer health insurance. In 2021, 12% of Floridians had no health insurance.
So, when Uncle Sam forced all states to cover children in Medicaid and the Children’s Health Insurance Program (CHIP) for 12 months, as of Jan. 1, 2024, Florida complied.
But — a catch. Florida is willing to enroll children, but wants to disenroll those whose parents don’t pay the premium during the 12 months. The court is considering Florida’s “authority of continuous disenrollment.” Florida can charge, and collect, premiums during these 12 months. Many families will pay them. But some won’t; and Florida wants to drop the children of deadbeat parents. Uncle Sam says no. In the current battle of Uncle Sam versus Scrooge, the court will wade through dense language to decide. If Scrooge wins, the children of Florida lose.
Forget the state’s heritage, embodied in its seal. In the seal, a Seminole woman is strewing flowers, with a palm tree in the background and a steamboat on the river. Edenic. But does that Seminole maiden have proper documentation? As an agricultural worker, does her employer - the person who owns the field where she is strewing - offer insurance? Where can she go if she goes into labor? Not a Florida hospital.
The state looks askance at anybody without documentation. The state has an Emergency Medical Assistance program for mmigrants. But a 2023 law requires hospitals to ask patients their immigration status and, presumably, show documentation. (https://www.politico.com/news/ 2024/06/23/desantis-florida-medicaid-immigration-00164519) Predictably, the state’s Medicaid expenditures have dropped as the people who need help — those who work in the fields and low-wage service industries - avoid hospitals. To be clear, Uncle Sam does bar undocumented patients from Medicaid; but states must allow payment for emergencies, including childbirth and dialysis. Before the hospital “ask,” the state spent $148.4 million in Medicaid dollars for emergency coverage of migrants; afterward, that expenditure plummeted. Ironically, the state had been spending more than half that emergency money for women in labor - a policy that jibes with the state’s decision to bar abortion, to sanctify “life.” Now those women in labor will bypass the hospital. Maybe, like the Seminole maiden, they will give birth in the fields.
As for the idyllic scene by the river, in the sweltering heat of today’s rising climates, farm workers will need breaks to rest, to seek shade, to drink water - the same breaks that we give ourselves, that we urge on our children, that we remind our parents and grandparents to take.The sweltering heat, coupled with high humidity, can be lethal. Florida depends on farmworkers; its Department of Health estimates that 150,000 to 200,000 people work in the fields. But after at least one farmworker — a 29 year-old man — died from the heat in 2023, the state showcased its mettle. Florida then passed a law banning local governments from requiring “heat breaks” for outdoor workers. (In contrast, after a farmworker died from heat, Oregon enacted emergency rules for emergency (now normative) spikes in temperature.)
We shudder at the meanness of Scrooge. We should also berate his stupidity. Florida, like the rest of the nation, depends upon a swathe of low-income workers, some documented, some not. We sicken — if not kill — them even while we depend on their energy and strength.
Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email joan.retsinas@gmail.com.
From The Progressive Populist, August 1, 2024
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