Keys look to improve access to health care

Enrollment for public health insurance is now open through Jan. 15, according to the Florida Department of Health in Monroe County, which is spreading the word in an effort to get more people covered in a county with a relatively high number of uninsured.

According to a report from the U.S. Census Bureau, 8.6% of the nation’s population did not have health insurance in 2020. The 2019 American Community Survey, the most recent study that provides county-level health insurance data, found that about 20.4% of Monroe County residents were uninsured. However, that study was operating under the premise that Monroe County had about 72,000 residents and had a margin of error of 3.5%. The census figures released earlier this year put the Keys population at 82,874.

Alison Kerr, a planning manager with the health department, said there are “multiple factors that may contribute to the high uninsured rate in Monroe.”

A 2019 report by the department lists the main barriers to health services as high cost of care, inadequate or no insurance coverage, lack of availability of services and lack of culturally competent care. That report lists the number of uninsured adults as 22%, and the number of uninsured children in the county as 13%, both higher than the state averages.

The public health insurance offered by Monroe County is through the marketplace of the Affordable Care Act, sometimes called Obamacare. The 2019 census report said that it’s estimated that about a third of Monroe County residents are covered through public health insurance and about 61% are covered through private.

That study also showed some disparity between ethnic groups and insurance rates. It estimated that about 83% of the county’s white residents had insurance while 77.5% of Black residents and just 70% of Hispanic Keys residents had insurance. It also showed that only 68% of foreign-born residents were insured, compared to 82% of native-born people.

The health department’s report said that about 53% of the potential public health insurance marketplace in Monroe County had signed up in 2015.

Bob Eadie, administrator of the county health department, said he doesn’t think that number has gone up much since then, partly because the state has never chosen to expand eligibility for Medicaid, limiting the pool of insurers that people can access.

Another factor may be that many jobs that are common in the Keys, such as charter captains, fishing guides and food service workers, do not offer to cover parts of the insurance premiums, Eadie said. One Upper Keys charter captain said that “hardly any” people in that profession have insurance unless they cover it themselves or they’re covered by their spouses’ plans. The captain said this is the case for many fishermen, mates, bartenders, servers and self-employed people.

Eadie said the affordability issue does come up in Keys medical facilities, but if someone’s life is in danger, hospitals will assist them no matter what.

“They’re not going to turn anyone away for a true emergency,” Eadie said. “For some people, the only medical care they have is the emergency room.”

The high cost of insurance and lack of eligibility in the Keys is part of what contributes to it being so expensive to live here, Eadie said.

The health department is working to promote the public insurance option. Kerr said she’s issued press releases and put out print, radio and digital ads and is working closely with health organizations such as the Rural Health Network, Womankind of Key West, Tavernier Health Center and Marathon Health Center to get people signed up for affordable healthcare insurance.

For more information, contact Womankind at 305-879-1965 or [email protected];

Rural Health Network at 305-517-6613, ext. 321; Marathon Health Center at 305-926-0259; and Tavernier Health Center at 786-387-9260.

Additional information is available at monroe. floridahealth.gov/insurance.

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