Johana has done everything “right.” After emigrating to America as a young woman, she immediately began working and quickly became a U.S. citizen. She works hard; pays taxes; takes care of herself and her elderly mother. With a subsidy through the Affordable Care Act (ACA) Marketplace, she purchased health insurance out of her meager salary as a line cook.

When the pandemic closed her restaurant, she lost her job. She briefly got unemployment but is now back at work part-time. When told she was exposed to COVID by a coworker, she got tested for the virus. Her insurance company told her the test would cost her $36.

But now, in spite of doing everything “right,” Johana, is now being billed over $500 for the COVID test.

“I don’t know what to do. I know how important it is to take care of myself and have insurance, especially with COVID. But there’s no way I can afford that.”

Johana called her insurance company when she got the bill. “How could this happen?” She was told she is no longer has her insurance policy, which had a monthly premium of about $55. Now, because her income is below the poverty level ($1064/month), she is no longer eligible for a subsidy to help cover the cost of insurance. She was told her $55/month policy now costs $600/month.

“I don’t know what to do. I know how important it is to take care of myself and have insurance, especially with COVID. But there’s no way I can afford that.”

Under the ACA as passed by Congress, Johana, along with more than 1.5 million fellow Floridians should have insurance through an expanded Medicaid program. But in 2012, the Supreme Court ruled that the ACA’s Medicaid expansion would be left up to each state. Years later, Florida and 11 other states STILL refuse federal funding to expand Medicaid coverage.

People like Johana are in the “coverage gap”: too poor to qualify for an ACA subsidy and not eligible for Florida’s limited Medicaid coverage. This needs to change.

“And now I have a bill for $500.” That too needs to change. The Florida Health Justice Project is working with Johana and the hospital where she was tested to get the bill covered.