Juakenia may live in Miami Beach but her life is not filled with the glitz and glamour of carefree tourists. She has no access to affordable healthcare and her housing situation is precarious, at best.

The ceiling of her affordable housing apartment caved in. Twice. When she was temporarily relocated to another unit, her landlord shut off the air conditioning, causing mold to grow on everything, including her bedding and clothes. She had to give up her beloved cat Logan. It’s all taken a toll on her.

“I’m in a bad spot right now,” Juakenia says. She’s displaced and depressed. She’s tired and sick. And she doesn’t have access to health insurance, including mental health services, to get the help she needs.

If Juakenia lived in one of 38 states that have expanded Medicaid, she would have affordable healthcare and be able to get an annual exam and access to a psychiatrist to treat her depression. Unfortunately, Florida is one of the few remaining states that have not expanded Medicaid, leaving almost 1 million residents like Juakenia out.

Medicaid in Florida currently only covers a few “categories” of very low-income adults. These include:

-Pregnant women

-Parents of minor children (eligibility is capped at income of just $458/month for single parent with one child; with Medicaid expansion single parent with child could make up to $ 2004/month and be covered)

-Those with disabilities.

“If I could see someone, I could get my blood pressure checked at least,” Juakenia says.. “I haven’t seen a doctor in a couple years.”

If she got better, she said she could go back to school or work in the school system where she once had a job. Right now, she gets by with help from friends and family who provide food and a little cash assistance.

“If I could see someone, I could get my blood pressure checked at least,” Juakenia says.. “I haven’t seen a doctor in a couple years.”

“I can’t do it myself”,” she says.

Juakenia’s options for accessing affordable health care are limited. Finding mental health services is even more difficult: She can seek basic primary care at a federally qualified health clinic that charges on a sliding scale, based on income. Unfortunately, mental health services are in high demand, with long waitlists and few public health low-cost clinics offer these services.

Juankenia can get help at Jackson Health System – which provides free primary care to county residents below 100% of the poverty level – and also provides a range of outpatient services. But all these options have co-payments that are often out of reach for low-income residents. Jackson Memorial System.

If Juakenia starts working and earning a minimum required income, she could apply for an Affordable Care Act (ACA) policy at www.healthcare.gov. The federal government offers subsidies that help make the monthly premiums for private health insurance plans more affordable. Enrollment begins November 1, 2021 for plans beginning January 1, 2021. All plans include annual exams and preventative services, such as vaccines, at no cost, without deductibles.

There’s one thing Juakenia can get for free now: A life-saving Covid vaccination. Covid vaccines are effective and proven to reduce the need for hospitalization and complications from the extremely contagious virus that can lead to disability and death. Covid vaccines are now readily available at local pharmacies and public health clinics for everyone age 5 and up. The Florida Department of Health also has pop-up clinics everyday in churches and community centers.

Until Florida expands Medicaid or increases funding for public health services, Juakenia and hundreds of thousands of Floridians like her have limited options and face an uphill battle staying healthy, particularly with the structural inequities entrenched in non-expansion states.