78,000 Kansans in health coverage gap, at risk for no insurance

By: Jason Tarr Email
By: Jason Tarr Email
The people in the gap are making too much to qualify for Kansas

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MT. HOPE, Kan. -- Food or Insurance?

That's the kind of decision Mt. Hope's Greg and Vivian McGraw face thanks to a coverage gap created by the Affordable Care Act and Kansas' choice to not extend Medicaid programs.

"We are outraged," Vivian McGraw said.

Greg lost his IT job about a year and a half ago when the company he worked for downsized. He and his wife Vivian searched hard for new jobs but found the market to be unkind.

"We've done everything we can to look for work," Vivian said. "We finally decided to make our own business."

They began an archery bow business, Smokey River Bows, out of their Mt. Hope home. The business is still in its early stages so the money isn't flowing in just yet.

That's left them in an income category that marks a gap in those eligible for affordable health coverage.

Because they find themselves in that gap, they don't qualify for Medicaid or government subsidies. They face out of reach premiums of up to $800 a month.

"It would be between feeding the family or paying insurance," Vivian said. "There's no choice: feed the family."

A recent report by the Kaiser Foundation shows an estimated 78,000 Kansans are in a similar position.

Why is that?

The Affordable Care Act was designed to expand Medicaid to people at 133 percent of the poverty level and below. The poverty level for an individual is $11,490 or $15,510 for two adults living in the same household.

But in June 2012, the U.S. Supreme Court ruled states could opt out of that Medicaid expansion.

Kansas was one of 25 states to do just that. In Kansas that left in place the rules that make Medicaid available to only those below 33 percent of the poverty level.

On a national level, a kink in the language of the Affordable Care Act, allowed for government assistance to buy private coverage to still be available to those 100 percent to 133 percent of the poverty level. That's the case even in states like Kansas where Medicaid was not extended.

That means in Kansas, those between 33 percent and 99 percent, like the McGraw's, are completely out of luck. The people in that group include low income, elderly, and those recently laid off.

"That group right there is still working and still contributing, but they can't get health insurance," said Hutchinson-based insurance agent Diane Roggow of Solid Financial Solutions.

Roggow says it ties her hands and there's nothing she can do.

"It kills me to say, 'I'm sorry, I can't help you,'" Roggow said.

The McGraw's are equally as frustrated.

Given they can't afford the health insurance premiums, they can and are applying for an exemption from the steep penalty they'd face for not having mandatory coverage. But there's no guarantee that application will be approved, leaving a lot of uncertainty when it comes to the future.

"Surely they can come up with something better than this," Vivian said.

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