Voices of Florida. Made possible through the generous support of the Gidel Family Foundation.

A mother’s struggle to insure her son

Seven months after moving to Florida, Irina Flores-Montalban found out that her 11-year-old son, Jose, had a blood clot in his heart and needed an operation. Because she had no health insurance, she was advised to enroll him in Florida KidCare, the state’s health insurance program providing subsidized coverage for low-income children.

But then the 38-year-old Sarasota mother was told that Jose — as well as his two siblings — was not qualified. Although they have a green card, the family did not meet the state’s five-year residency requirement.

In Florida, lawful immigrants are eligible for public benefits such as Medicaid and Florida KidCare only if they have been residing in the United States for five years. Under the 1996 welfare reform law — which introduced restrictions for federal income-based benefits related to immigration status and length of U.S. residency — 22 other states, plus Washington, D.C., enforce the same eligibility requirement.

“I didn’t know that every state is different,” Montalban, an Ecuadorian immigrant, said in Spanish. “In New York, where we used to live, they just asked me to fill out the form and soon I got the medical cards in the mail.”

Desperate, she asked one of her children to go online and look for a cardiologist. At the time, Jose had already been experiencing frequent nosebleeds. “I was getting frustrated, but determined to get my son treated. I was willing to pay the consultation fees,” Montalban said.

When they arrived at the doctor’s office, the doctor informed her that Jose had a congenital heart condition, indeed was “a ticking time bomb.” Because he needed to have an operation right away, the doctor’s aide helped put Jose in an emergency-care program, but the post-operation medical bills were not covered.

After separating from her husband, Montalban and her three young children – Margarita (17), Emilio (9) and Jose – moved from New York to Florida to start a new life. Her brother bought a house in Sarasota, asking her to take care of the house and have their mother live with them.

That way, she could save rent and, at the same time, her children would be closer to their grandmother, she said.

Montalban works part-time at the clothing retailer Forever 21 and earns about $600 a month, enough to cover food costs and other basics. Several days a week she attends an ESL class at a local community center. But that routine was upended the day she registered Jose for school. When he took the required physical exam, nurses discovered his blood pressure well above normal. They later learned of clots in his aorta.

His condition is congenital, Montalban said, and he may need a cardiologist for the rest of his life. Aware that her kids were ineligible for Medicaid, she found herself facing a painful dilemma: Choosing which of them to insure.

In Florida, lawfully residing immigrant children are ineligible for the subsidized program, but can secure coverage through Florida Kidcare’s full-pay option – with the cost being between $139-196 dollars per month per child.

The choice was clear.

“I had no choice but to get health insurance only for Jose. I pay $141 a month for his insurance. I would not be able to afford insuring my other children, so I pray that they won’t have the same health problems.” Montalban then added that passage of legislation removing the five-year waiting period would be “more than a blessing” for her and her children. “If they qualify for Kidcare, I’ll only be paying $20 a month to cover their health insurance,” she said. “I know that there are a lot of people who are in my situation.”

In 2013, legislation was introduced in Tallahassee that would remove the five-year waiting period. Legal immigrant children, like Irina Montalban’s, would no longer have to endure such waiting requirements in assessing their eligibility into Florida KidCare. The Children’s Movement in association with KidsWell Florida are leading advocacy efforts to see that these bills are successfully passed and implemented.