Working as a Family Man in Florida

Last week, I was traveling through Florida on vacation (I know, I know, I was sure to cover my luggage in Pride stickers first). My companion and I were taking a taxi to a hotel, and the driver mistakenly took us to the wrong Marriott. No big deal - there were like a dozen Marriott's in the city and the right one was less than ten minutes away.

The driver apologized and said he had a lot on his mind. He told us that his wife had been fighting stomach cancer for a year, and he was expecting the call from the hospital at any moment that she had passed. He talked about how her face had changed completely during her illness. He said they had three children between the ages of 8 and 15.

I don't think he was meaning to give us a sob story. Up until this point he was playing Christian music on the radio, turned up loud enough to avoid talking with us.

So why on earth was this man driving us around in his taxi? He should instead be with his dying wife. He should instead be with his children. He should instead be at church on this sunny Sunday morning finding support through his faith and his community.

He didn't say as much, but I think he was driving his taxi to keep his family's household income high enough to qualify for subsidized health insurance through healthcare.gov.  If his income ever fell below 100% of the federal poverty level ($37,650/year for a family of five), he would lose access to all assistance and his monthly health insurance premiums would skyrocket. He was working so he could pay for his wife's medical care.  

In most other states, this would not be an issue. In most other states, if his income was below 138% of the federal poverty level ($51,957/year for a family of five), his entire family would qualify for free healthcare under the Medicaid program. Unfortunately, Florida and nine other states have made the political decision to refuse federal dollars to provide free health coverage to their lowest income residents. So, ironically, if he's poor enough, he gets generous federal funding in the form of ACA premium tax credits and cost sharing reductions (CSRs).  But if he's too poor, he gets nothing.

I don't know all of the details here. His kids probably qualify for CHIP health coverage through the state. Maybe he and his wife can qualify for Medicaid due to being caretakers of children under 18 (several non-expansion states have something like this). But wouldn't it be easier and more humane to provide coverage to low-income families with less administrative overhead?

If he lived in a different state, he and his family might qualify for free healthcare through Medicaid (even if he still chose to work some). He might be eligible for paid family medical leave (PFML) to care for his wife, even as an independent taxi driver (e.g. MA). His wife might qualify for special programs to provide extra financial assistance to people diagnosed with cancer (e.g. CT).

I'm making up a lot of details about a person who I barely met. But it breaks my heart that we have a nation of haves and have-nots based on the compassion or cruelty of state lawmakers.