Of the uninsured Kansans who stand to benefit from KanCare expansion, three in four are in a working family, according to recent studies. These families to do not earn enough to qualify for tax credits to buy insurance. Yes, you read that right — they do not earn enough to qualify for assistance.
That’s because the Affordable Care Act (also known as Obamacare) also included a provision to expand Medicaid for all those who didn’t earn enough for tax credits to buy insurance. However, a Supreme Court decision made expansion optional for states — 30 states have expanded their programs, but Kansas is one that has not.
That means this incredible scenario is now possible in Kansas:
- One family of four earns $24,250 a year and qualifies for tax credits to pay for most of the cost of health care coverage for the family;
- At the same time a family of four next door earns $24,000 and does not qualify for any tax credit assistance and probably can’t afford to buy coverage.
However Kansas elected officials could end this scenario now with KanCare expansion, providing coverage to about 150,000 Kansans.
Dr. Julie Elder of GraceMed Health Clinic in Wichita wrote an appropriate response to Rep. Hawkins’ claims, published Dec. 12 in the Eagle:
A commentary by Rep. Dan Hawkins, R-Wichita, was disappointing to read, as it did not reflect the reality I see every day as a practicing physician and chief medical officer of GraceMed Health Clinic (“Able-bodied have health care options,” Nov. 24 Opinion).
Hawkins has visited our main clinic and has been part of discussions pertaining to the limited health care options available to hardworking, uninsured Kansans. His commentary suggested that Kansans who stand to benefit from KanCare expansion are “able-bodied adults with other health care options.” This is not entirely true.
The reality is that most uninsured Kansans are working, and those we see in our clinic are frequently working more than one job. But that doesn’t mean they have the opportunity to enroll in a health insurance plan.
In fact, many of our friends and neighbors work part-time jobs with restricted hours that exclude them from employer-based health insurance coverage. Many make too much money to qualify for our current state Medicaid plan, but not enough to afford health insurance through the Affordable Care Act’s subsidized insurance marketplace.
The notion that people who would benefit from KanCare expansion are simply looking for a handout is a false stereotype. The truth is that most are our neighbors, who are working hard to make ends meet and yet do not have the employer-based health coverage options typically associated with hard work.
Without health insurance coverage, even hardworking Kansans have very limited access to health care. Safety-net clinics, such as Grace- Med, provide primary care services for uninsured patients. But many patients need more than primary care. At times, they also need to be hospitalized or need surgery, prescription drugs, treatment for chronic conditions or care from a specialist. These people often come to GraceMed with severe and uncontrolled health conditions due to a lack of access to affordable care. For services not offered at GraceMed, patients must find donated care, find a way to pay out of pocket or forgo care. In the most extreme situations, people die.
This leaves most Kansas patients who fall in the coverage gap with no realistic health care options, other than the emergency room. And the purpose of an ER is not to provide nonemergency care.
KanCare expansion would change this reality for more than 150,000 Kansans who are in the coverage gap, and proposals have been offered to expand KanCare without raising taxes. The state of Indiana, with a Republican governor and Legislature, expanded its Medicaid program with requirements that expansion be budget-neutral and that eligible recipients who are not currently working be required to seek training toward employment.
I urge legislators to set aside ideological biases and pragmatically evaluate and consider KanCare expansion for 150,000 Kansans currently in need of health insurance coverage.
Health care access should not be a privilege reserved only for those of us who are fortunate to work for an employer that offers such a benefit; it should be a right for all of our friends and neighbors.
—Julie Elder is chief medical officer of GraceMed Health Clinic in Wichita.