Routine care and trips to the emergency room can be bank account breakers if you don't have insurance.
The Affordable Care Act makes subsidies available for millions of individuals and families. But here's something that may surprise you. The poorest of poor in Kansas will see no benefit at all.
A key U.S. Supreme Court ruling allows states to opt-out of the Medicaid expansion outlined in the law. The original intent was to expand the Medicaid system with mostly federal funding to cover millions of people who are currently ineligible for coverage. However, Kansas is one of 24 states that has chosen not to expand Medicaid.
"If you have an income that falls below 100% of the federal poverty level, you get nothing," said Cathy Harding, Executive Director of the Kansas Association for the Medically Underserved.
"Our navigators will work with them and see if they can qualify for the subsidies. And at the end may have to say, in many cases, 'We're sorry, you're too poor to qualify for any help'. And that will be a hard conversation to have with these people."
State could opt-in
Kansas Insurance Commissioner Sandy Praeger is hopeful, but not optimistic, the state will change its position on the Medicaid expansion. States can opt-back in. But they will lose a year of 100% federal funding for the expansion. They'll also be responsible financially when the cost shifts to a 90-10 split in 2017. Praeger says Kansas is giving away money.
"Those are our tax dollars that are going to Washington and they're going to be parceled out to states that do the Medicaid expansion. So in a sense our tax dollars are going to be helping people in other states."
Kansans in the Medicaid gap can continue to get treatment from safety net clinics across the state. But experts say they won't get the preventative care that's so crucial to leading a healthy life.