Hillsborough has expanded its free health plan – but few are biting

In December, Hillsborough County commissioners voted unanimously to expand the county’s health plan, a safety net for the vulnerable group of residents who don’t qualify for Medicare or Medicaid but make too little to afford marketplace insurance.

More than seven months later, however, less than half of the program remains.

The expansion raised the income ceiling for the program from 138 percent of the federal poverty level to 175 percent, meaning single people earning about $1,980 or less a month would qualify. And it added dental coverage, another sign of the program’s steady fiscal recovery since the crisis of the first decade of the 2000s. It was, Commissioner Harry Cohen said at the time, “a great holiday gift for our entire community.”

However, it seems many Hillsborough residents who could have qualified never unwrapped that gift. The program has recently averaged about 15,000 open spots a month, a county spokeswoman said. Philip Conti, who directs the Hillsborough County Health Services Plan, said monthly enrollment fluctuates but has recently hovered around 13,000, down about 1,000 people. from last year’s average.

“We’re really trying to make this accessible to everyone,” Conti said. “We want more people to take advantage of it. And when we do public events or things of that nature, we do hear from people that, “Oh, I didn’t know about that.” And mind you, this has been around for almost 30 years.”

The program, which began in 1991, offers a range of free medical coverage: primary and specialized care, dental and pharmaceutical services, hospital hospitalization. It aims both to help poor people get basic and preventive care and as a safety net for people who might otherwise be buried under a mountain of debt after a medical emergency. Conti mentioned a recent Tampa Bay Times story about a Pasco County man facing $170,000 in bills after an ankle injury.

“If it was in Hillsborough County, this wouldn’t have happened,” Conti said. “We were going to cover everything.”

County Commissioner Gwen Myers was surprised to hear the expansion didn’t appeal to residents. Her district includes many minorities residents who are financially vulnerable – especially amid skyrocketing housing costs – and who could benefit from the plan. She said she took the news as a personal challenge to spread the word through churches and community organizations.

“I’m going to make sure everybody knows we have this health care program,” she said. “We’ll change that within a month.”

Florida is one of 12 states that has not expanded Medicaid, exacerbating what health experts call the “coverage gap” of people who make little money but don’t qualify for Medicaid. Researchers have found that the gap disproportionately harms people of color.

That’s reflected in Hillsborough County, where nearly 30 percent of those enrolled in the plan this year are black, a fraction more than the county’s population as a whole. However, the plan’s demographics also skew older, with only 1 in 5 enrollees under 35. And despite the change in the income cap – which followed a similar expansion in 2019 – less so over 15% of participants are above the federal poverty level.

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Conti can only speculate why the expansion did not attract more residents. One factor may be that in a rapidly growing region, newcomers are simply unfamiliar with the county’s social services. He also noted that entering the plan requires a form of identification, proof of residency, a list of assets and, for those employed, income records. regarding 1,200 people a month start the application process, but many don’t follow through.

Given that many who may benefit are members of communities that have historically suffered from institutional neglect, he added, “there may be an underlying distrust of county government.”

The plan already recruits participants through outreach events, outreach to law enforcement and the county jail, and the health care providers that make up the plan’s network of 36 facilities. Conti said his agency is working with the county’s communications department to figure out how to target groups that don’t benefit from the plan.

“This is our attempt to try to level the playing field when it comes to access to health care,” he said. “This is not a complete solution. But for now, it’s probably a better place if people take advantage of it.

How to get help

To get more information or to apply for the health care plan, go online to https://tbtim.es/hillshealthcare or in person at Tampa Family Health Center or Suncoast Community Health Center.

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