Health & Safety

Close the Gap Campaign

Under the Affordable Care Act, nearly all U.S. citizens and Legal Permanent Residents (who did not already have insurance) were entitled to either assistance paying for health insurance through the marketplace or enrollment in an expanded Medicaid program. However, in 2012, the United States Supreme Court held that states were not required to accept federal funding to expand their Medicaid programs, and to date, the Florida Legislature has chosen not to.


This has resulted in approximately 750,000 Floridians, and 150,000 Miami-Dade County residents falling into the “Coverage Gap.” In essence, these people are too poor to be eligible for the federal subsidy help to purchase coverage on the marketplace and yet are not eligible for Florida’s extremely limited Medicaid program for adults.


This project will address this problem in multiple ways. First, we will identify county residents who fall into the “Coverage Gap.” In collaboration with the Community Justice Project (CJP), which supports local grassroots work in Miami, we will enable county residents in the Gap to engage in state level advocacy to expand Medicaid. In addition, we will continue our advocacy related to Miami’s existing safety-net system. Until the Legislature accepts expansion funding, it is critical that county residents have access to health care services, regardless of their ability to pay. Furthermore, our clients’ stories will inform our policy briefs and analysis papers that are used by elected officials, key community stakeholders, media networks, and the public to understand how failing to accept the federal funds adversely impacts Miami-Dade County residents.

Who are you?

The Florida Legal Services Miami Advocacy Office has been engaged in systemic advocacy to ensure justice for all since 1996. This project will be led by a senior health law attorney, an Equal Justice Works Fellow, and CJP.

How does this project impact the issue you selected?

This project will continue our longstanding efforts to ensure county residents have access to health care. By both advocating for the expansion of Medicaid and ensuring that current uninsured residents can utilize the existing safety-net system, we will work to ensure access to care both now and in the future. Moreover, we will ensure that our elected officials understand the positive impact that accepting the funding will have on their constituents, as well as the danger of failing to do so.

What data points from The Our Miami Report does your project address?

As the “Our Miami Report” indicates, Miami has the highest rate of uninsured when compared to other major cities. By advocating for the expansion of Medicaid, we will be working towards reducing the rate of uninsured residents. As a result of having insurance, these individuals will no longer rely on the ER, reducing costs for the community. Furthermore, covering those who currently fall in the “Gap” will reduce stress on the safety-net system, ensuring its viability for those not eligible.

Please give examples of your project's success.

The ultimate sign of our project’s success will be Florida legislature’s decision to accept federal funding to expand access to care for low-income Floridians. As we work towards that goal we will enable Miami-Dade residents to make their voices heard on why this issue matters to them, while simultaneously ensuring that the existing system continues to serve those in need.

Organization Name (or individuals name) Florida Legal Services



16 votes
Idea No. 109