ST. PETERSBURG — Elisa Abolafia leaned her cane against the railing in front of City Hall and gingerly stepped to the lectern.
The 60-year-old former private investigator suffers from severe scoliosis and four ruptured discs. Looking for work and too young for Medicare, Abolafia said she recently found out she is in the so-called Medicaid coverage gap, so she pays out-of-pocket for a patchwork of medical care.
On Thursday, she stood beside Mayor Rick Kriseman and City Council member Darden Rice and pleaded with the state Legislature to accept federal dollars to expand the Medicaid program in Florida.
"I'm a combination of scared and angry, like why is this happening to me?" Abolafia said at a news conference.
Kriseman and Rice have joined a chorus of local officials pressuring lawmakers to accept $50 billion over 10 years offered by the federal Affordable Care Act. Under the law, states were supposed to expand Medicaid eligibility to nearly all adults with incomes at or below the poverty level. But a Supreme Court ruling in 2012 made Medicaid expansion a state option.
An estimated 800,000 Florida residents — including roughly 54,000 in Pinellas County — do not earn enough to qualify for federal financial aid to buy a private plan on the ACA exchange, but earn too much to qualify for Medicaid. Florida's Republican-controlled House of Representatives has refused to accept federal funding to fill the gap.
Kriseman called that a failure of leadership. "Hopefully, we'll all be able to advocate for the changes that need to occur," he said.
Health care advocates with the groups that organized Thursday's event — Florida CHAIN, Florida Consumer Action Network and Doctors for America — say they are encouraged by an alternate proposal released this month by a coalition of state business interests and private citizens, including some prominent Republicans. Dubbed "A Healthy Florida Works," the plan would use federal money to expand coverage but require beneficiaries to pay premiums and, if unemployed, to search for work or enroll in job training programs.
Progressive groups worry that those requirements could place an undue burden on some beneficiaries, but see the pressure on the Legislature as a positive sign, said Athena Smith Ford, advocacy director for Florida CHAIN.
"It certainly reflects the reality that the hospitals are getting hit really hard with uncompensated costs," Rice said. "If they're willing to have discussions to look at ways to take this federal money, we have to remain optimistic."