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NAPLES — Enrollment in the Florida Medicaid program has risen nearly 19 percent in Southwest Florida in the past year, a sign of huge job losses and the financial squeeze that families are facing.

In Lee County alone, Medicaid enrollment increased 23 percent from August, 2007 through August, 2008, while the enrollment increase was about half that, at 12 percent, for the same time period in Collier County, according to the state Department of Children and Families.

Local DCF officials nevertheless say the increases are not out of the ordinary. Ironically, they spend a lot of time explaining to people that they don’t qualify for Medicaid.

“What happens is they can no longer afford their insurance premiums so they stop paying to save their home and apply for Medicaid but they are not eligible,” said Susan Wright, Medicaid program administrator in Collier, Hendry and Charlotte counties.

“We don’t even have a coverage category for them and they are dismayed,” Wright said.

Medicaid in Florida covers low-income families with children, pregnant women, the elderly or disabled who are not receiving Social Security Income, and non-citizens with temporary medical emergencies. Those who are not eligible are single people or married couples who don’t have children, said Kathleen Spiak, Medicaid program director in Lee County.

“We always have people who think they are eligible,” she said. “Most people do have that assumption or they come from another state where they may have had Medicaid.”

Still, people are losing their jobs and that is making their children eligible for coverage and that accounts, in part, for the higher enrollment figures in the region, said Erin Gillespie, DCF spokeswoman for Southwest Florida.

The statewide Medicaid enrollment increase from August 2007 through this past August was 9.5 percent, according to DCF.

The average Medicaid enrollment increase nationwide in fiscal 2008 has been 2.1 percent, which erased enrollment declines from the year before, according to the Kaiser Family Foundation.

For fiscal 2009, enrollment growth is projected at 3.5 percent, according to the non-partisan group based in Washington, D.C. The foundation surveys state Medicaid directors annually to assess the programs.

From a different perspective, Medicaid spending grew an average of 5.3 percent in the U.S. this year and is expected to increase next year another 5.8 percent, at a time when state budgets are financially strapped because of the failing economy and declining state revenue, according to Kaiser.

The survey of state Medicaid directors found that 30 states, including Florida, are struggling with significant budget constraints and the expectation is a good chance of shortfalls for Medicaid programs this year and having to make cuts in eligibility and outreach efforts next year.

“We’re just beginning to see the impact of the economic slowdown as growing Medicaid enrollment and shrinking revenues pose new threats for health coverage,” Diane Rowland, executive vice president of Kaiser, said in a statement.

What’s causing many people to come into DCF enrollment offices are requests for immediate help, to get food stamps and temporary cash assistance, Spiak, the Medicaid program director in Lee, said. For instance, applications for food stamps has gone up 61.5 percent since August, 2007.

“Medicaid may not have been what drove them in the door,” she said.