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With Medicaid expansion off the table, entrepreneurs and nonprofits help Florida's uninsured

Yessica Gonzalez, left, is the founder and general manager of Clínicas y Farmacias Dr. Goodprice, a clinic and pharmacy in Little Havana catering to uninsured and undocumented patients.
Verónica Zaragovia / WLRN
Yessica Gonzalez, left, is the founder and general manager of Clínicas y Farmacias Dr. Goodprice, a clinic and pharmacy in Little Havana catering to uninsured and undocumented patients.

Roughly a year ago, a block on Northwest 12th Avenue in Little Havana gained a new tenant. In addition to a barber shop, a nail salon, and a Nicaraguan restaurant it now also has Clínicas y Farmacias Dr. Goodprice, a clinic and pharmacy founded by Yessica Gonzalez.

The business caters to people who are undocumented and uninsured. “There is a big problem here in Miami, of lack of access to health care,” said Gonzalez.

All of South Florida's counties have a higher rate of people 65 and younger without health insurance than the state, which is at 13.9%. According to the United States Census Bureau, Monroe County's uninsurance rate is 18.7%, Miami-Dade's rate is 16.7%, Broward is at 15% and Palm Beach County's rate is 16.5%.

When people are uninsured, they tend to skip preventive checkups or care for chronic conditions, say health policy researchers.

Gonzalez says she tries to keep costs down so that care at her business can be affordable without insurance. Staff at Dr. Goodprice include people who worked as doctors overseas but in the U.S. have licensing to work as nurse practitioners, “which allows them to diagnose, to prescribe," Gonzalez said.

This is one way to keep costs down.

The majority of her patients speak Spanish, so she hires bilingual staff and signs are written in the language, too.

Dr Goodprice client Doris Peña

'God put it here'

On a recent afternoon, Doris Peña came in to get care for her 9-year-old grandson.

“I’m bringing him in an emergency, because they called from his school that he needed to be picked up,” she said to Gonzalez.

Peña’s grandson had a fever and nausea. A consultation with the nurse practitioner costs a fee of $25. Other services at Dr. Goodprice include physical exams for $35 and pap smears for $95.

The pharmacy within the same space only fills prescriptions using generic drugs and they sell generic over-the-counter products.

“This place is something God has put here for anyone who’s Latino and poor,” Peña told WLRN. “Medications are much cheaper here than in other places.”

Another client, Ana Martinez, suffers from migraine headaches and has problems with her blood pressure. She had gone to see a doctor at Jackson Memorial Hospital, but this was her second visit to this clinic.

“Jackson’s next appointment with a specialist was a month-and-a-half away and I can’t wait that long when I have problems with my blood pressure,” Martinez said.

READ MORE: 'Trying to survive': Families suddenly dropped from Medicaid seek reinstatement

Advocates for Medicaid expansion say lawmakers should accept federal money to make more low-income adults eligible for this state and federal partnership. Under the Affordable Care Act, federal dollars enable states to cover more adults under Medicaid by increasing the income eligibility cap.

One advocate for expansion is Dr. David Woolsey, an emergency physician at Jackson Memorial Hospital in Miami. During a recent press conference, he said that typically when patients come to the ER, he and his colleagues treat not comprehensive care but acute illnesses — which may result after the patient had attempted to tough it out at home to avoid paying for a visit to the doctor.

Woolsey explains often, his job is "making sure that you don’t die today or you don’t die from the current problem that you showed up with - and at the end of which you’ll go home with a giant bill that really impacts your future."

Emergency care, he cautioned, can lead people to the financial ruin they tried to avoid by skipping checkups.

It's an issue driving the work of two Miami-Dade nonprofits seeking to help people with mounting medical bills. They recently received grant funding to develop a project in partnership.

“One piece of that work is educating people about medical debt, about what their patient rights are, about how to contend with medical debt when one receives a bill,” said Alison Yager, the executive director of one of the nonprofits, the Florida Health Justice Project.

“People of color have fewer financial reserves to lean on and therefore more reluctance to acquire medical bills or accrue medical bills.”

Until Yager launches the project, alongside partner organization Catalyst Miami, these nonprofits have been advocating for Florida to join the 40 Republican and Democratic states that have expanded Medicaid eligibility.

“Good health outcomes ought not be a partisan issue,” Yager said. “Everyone has a body. Everyone has a mind. We all need and deserve access to health care.”

Putting expansion on the ballot

The president of the Florida Senate, Kathleen Passidomo, said at the start of the 2024 legislative session in January that the Legislature would not expand Medicaid.

“I want to be clear. I’m not going to spend the next 60 days re-litigating Medicaid expansion,” she said. “If you cannot actually schedule an appointment with a health care provider, Medicaid expansion is nothing more than a false government promise.”

A coalition of groups focused on healthcare access and affordability is working to put Medicaid expansion up to voters instead. The effort is called Florida Decides Healthcare.

In an online press conference on Feb. 1, campaign manager Jake Flaherty said: “Today is the start of a concerted effort for us to get Medicaid expansion on the ballot in 2026. Floridians have the chance to provide 1.4 million of our friends and neighbors with access to affordable and quality healthcare.”

He’s referring to the 1.4 million low-income Florida residents who do not meet Florida’s strict Medicaid eligibility requirements.

This campaign is aiming to gather roughly 1 million signatures from voters across the state by the end of 2025, in order to meet all of the state requirements by the official Feb. 1, 2026 deadline. It also has to get approval of the ballot item’s wording from the Florida Supreme Court. If it makes it on the ballot, 60% of voters would have to approve.

Copyright 2024 WLRN 91.3 FM. To see more, visit WLRN 91.3 FM.

Verónica Zaragovia was born in Cali, Colombia, and grew up in South Florida. She’s been a lifelong WLRN listener and is proud to cover health care for the station. Verónica has a bachelor’s degree in political science and a master's degree in journalism. For many years, Veronica lived out of a suitcase (or two) in New York City, Tel Aviv, Hong Kong, Las Vegas, D.C., San Antonio and Austin, where she worked as the statehouse and health care reporter with NPR member station KUT.