Preventable hospitalizations, such as those of my patient, are routine here in South Florida, which has both an abundance of low-income, disabled residents and a barebones safety-net health system that has grown increasingly byzantine over the years. In the wake of the U.S. Supreme Court's ruling on the Affordable Care Act (ACA), Florida's governor, Rick Scott, declared that the state won't expand Medicaid eligibility, a move that will leave 1.8 million low-income Floridians uninsured. Compared to these folks, the low-income women, children, and disabled Floridians who do qualify for Medicaid are relatively lucky—at least they have some insurance. But they live in a state with a Medicaid program that is far from user-friendly, and doesn't guarantee consistent care.