The really desperate come early. George Bishop, 61, a lanky, gray-haired cabinet builder in a tropical shirt, has a red, swollen nose from a boil caused by his third sinus infection in the past five months. Diana Rios, 54, cheerful despite the arthritis pain in her back and knees, holds on tight to her purse and to her seven-year-old granddaughter and translator, Sofia. Lindsay Oliver, 28, is here because of hypothyroidism, Sjögren's syndrome (an autoimmune disorder), anemia, chronic hives—and no insurance.
By 4 p.m. on a rainy winter afternoon, they are part of a small crowd assembled on a grassy field behind a chain-link fence outside the Palmer Feed Store in Orlando, Florida. Across the street is the county medical building, where volunteer doctors affiliated with the nonprofit group Shepherd's Hope see uninsured patients on weekday nights. The clinic doesn't start until 6, but it's a first-come, first-served operation, and demand is high.
Illustration: Scott Anderson
At 4:30, a security guard opens the doors to let the patients in out of the drizzle. Dozens of them soon fill rows of metal chairs in the lobby. They are anxious and ailing, but also chatty as they munch on the cookies offered up by the volunteer clinic manager. Many have multiple medical issues going wholly or partly untreated. Rios is here for "private" problems as well as back pain, arthritis in her knees, and bursitis in her shoulder that forced her to quit working in September when she could no longer lift the trays she helped prepare for an airline food company. As Sofia translates, Rios explains that she has been in Florida for 16 years but has never had health insurance. She ended up in the emergency room recently after she fell on her arm and was so immobilized that she couldn't brush her teeth.
The raven-haired Oliver lost her job as a bank teller supervisor in July, leaving her and her three-year-old son uninsured. After months of unsuccessful job hunting, she finally signed on as a housekeeper at a Disney hotel. She's gone without some of her expensive medications since August and is hoping the clinic can help.
Oliver, Bishop, and Rios are among the nearly 4 million Floridians who lack health insurance—more than 1 in 5 in a state with the second-highest rate of uninsured in the country. Obamacare is supposed to help fix that through a combination of new federal subsidies for private insurance as well as a generous expansion of Medicaid, the government insurance program for the poor and disabled.
But the people at this clinic may not see many of these benefits, because Gov. Rick Scott and a tea-party-dominated state government have been at the forefront of the revolt against the law—and virtually every other form of government spending.
Similar shifts have occurred in other states where the tea party has amassed political power, including Michigan, New Jersey, Ohio, Texas, and Wisconsin. But no state has gone as far as Florida, where small-government advocates have seized the economic crisis and fiscal downturn to reshape the state, often sacrificing benefits for residents to make a broader political point.
Now, the Sunshine State may be a harbinger of another realignment: Support for Scott and the GOP is plummeting as Floridians see anti-government governance at work. But it may be too late for buyer's remorse. After two years at the helm, the tea party's legacy is likely to far outlast the movement.
WHEN HE RAN FOR governor as a political neophyte in 2010, Rick Scott's main credential was his vast wealth, much of which he accumulated running Hospital Corporation of America. During Scott's tenure, HCA was caught systematically defrauding federal health programs of millions of dollars through elaborate schemes to overbill the government for various services, including care it never provided. In 2000, the company pleaded guilty to 14 federal felony charges and paid $1.7 billion in fines in what was the largest government fraud settlement in history. A few months after the federal investigation was announced, Scott was forced to resign, but not before snagging a $310 million golden parachute.
Florida has never been known as a big-government state. An economy driven by tourism and real estate speculation has at times made it a haven for the less-than-scrupulous rich—Florida law helped O.J. Simpson shelter his assets in a mansion near Miami and avoid paying a civil judgment he owes Nicole Brown's family. With no personal income tax, Florida collects some of the lowest taxes in the nation, leaving the government chronically starved for cash.
Even so, Scott rode into office with a promise to slash spending further. He unveiled his first budget in February 2011, at a private meeting with tea party activists, and publicly released it at a tea party rally.
At one point Gov. Rick Scott was considered a rising GOP star and presidential contender. Now his approval rating is in the dumps, and even tea partiers want him out.
The "jobs budget," as Scott dubbed it, called for $4.6 billion in spending cuts, with education taking the biggest hit ($3 billion). It included a 17 percent cut to the agency that serves the disabled and proposed dropping virtually everyone but children and pregnant women from a state health program for the medically needy. The savings would be used to slash the corporate income tax from 5.5 to 3 percent, with the goal of eliminating it entirely by 2018. The budget also called for reducing property taxes by $1.4 billion, and cutting unemployment insurance taxes by $300 million, even though Florida's unemployment trust fund was bankrupt. US News columnist Peter Roff dubbed Scott's budget a "tea party dream" and speculated, somewhat prematurely, that it "almost assuredly gets him on the short list for vice president in 2012 or, depending on the outcome of that election, for president in 2016."
The effects were felt almost immediately, from the state level—nearly 4,500 state jobs were eliminated—to local governments. In Broward County, the school system laid off 2,400 employees, mostly teachers. The Polk County school district sacked all of its college advisers, a move that prompted the wife of a tea party congressman, Rep. Dennis Ross (R-Fla.), to spearhead a fundraising effort to try to save them. (In the end, Cindy Ross, a member of a local high school's booster club, wasn't able to preserve the jobs, which had previously been protected by the 2009 stimulus—a measure her husband ran against.)
Florida already had a 10.6 percent unemployment rate and one of the stingiest unemployment benefits in the country—recipients max out at $275 a week. After Scott's cuts, the percentage of unemployed people who received benefits fell from 17 to 15 percent—far below the national average of 27 percent. One reason: Florida now requires the jobless to take a 45-minute online math and reading test before even applying for benefits, a move the National Employment Law Project calls an "unnecessary burden" that may violate federal law. "Nowhere in the country is it this hard to get help when you lose a job," said Valory Greenfield, a staff attorney at Florida Legal Services.
ON THE DAY I WENT to visit Abdel Rahman Gasser, a half-dozen elderly people, some attached to oxygen tanks and other medical equipment, were parked in wheelchairs outside Lakeshore Villas in Tampa, looking out across a parking lot and a small lake. Inside the lobby, a young girl plinked out Christmas carols on a piano while other kids sang to a group of residents, none of whom looked much younger than 80.
Abdel Rahman Gasser, 17, is stuck in a nursing home. The state rejected Obamacare subsidies that could help bring him home. Photo: Gasser family
Abdel was also in a wheelchair, but when I met him in a conference room and asked his age, he smiled broadly and declared, "Sixteen years old!" Actually, Abdel is 17, but his brain no longer works the way it used to.
One rainy night in 2011, he and his brother were driving home from the beach when their car slid off the road and hit a concrete pole, which fell over and smashed the vehicle. Doctors eventually removed part of Abdel's skull to relieve life-threatening swelling in his brain. He survived, but with the cognitive ability of an infant. He had to relearn how to breathe on his own and only recently began speaking in full sentences again. He can't walk and has to be fed through a tube in his stomach. He gets confused about his name, though he recognizes his family and seems especially fond of his brother Tarik, who joked with him and held his hand while we visited.
Since June 2011, when he was released from Tampa General Hospital, Abdel has been here at Lakeshore Villas, a geriatric nursing home that also houses medically fragile children. He goes to a public high school for part of the week for a change of scenery and spends the rest of his time watching TV. Before his accident, Abdel, who was born in Egypt, was still becoming fluent in English. But his caretakers at Lakeshore don't speak Arabic, making his isolation profound. (Nursing home administrators, who told me to leave when I came to visit with Abdel's family, did not respond to a request to comment for this story.)
Abdel's father, Gamal, is a compact, dignified man with gray-flecked hair who works as an engineer. He'd like to bring his son home. "Every time I walk in to see him, it's like he's doing nothing," he says. "When he hears my voice or hears his brother's voice, he's like screaming and shouting. I'm sure it'd be much better if he comes to my house." But Gamal, 58, and his wife cannot care for Abdel without help. They can't lift the 160-pound teen, and they certainly can't leave him home alone while they go to work.