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Despite Obamacare, Insurance Disparities Persist In Kansas

Bryan Thompson
Heartland Health Monitor

A recent report credits the Affordable Care Act, or Obamacare, for helping to reduce the racial and ethnic inequalities in health insurance coverage. But Kansas has not made as much progress as other states. Heartland Health Monitor’s Bryan Thompson investigates why—and what can be done about it.

Before the Affordable Care Act, people of color were much more likely than whites to be uninsured. But an analysis by the non-profit Center for Global Policy Solutions shows that gap has narrowed because of the health reform law—narrowed, but not disappeared.

Ocie Corner is one example. The African-American woman lives in Bel Aire, a suburb on the northeast side of Wichita. Corner hasn’t had insurance since 2012. She says she just kept her fingers crossed.

“You just hope you don’t get sick and have to go someplace, because...you really don’t know where to go. You really don’t," she says. "You just kind of, ‘Well, it’ll work out. It’ll work out.’ And, you know, sometimes it don’t work out.”

Corner wasn’t aware of the federal insurance marketplace that became available in 2014. But a few weeks before last Christmas, she saw a message on TV about the penalty people have to pay if they don’t have health insurance.

“I wasn’t paying no $600, so it got me to sign up," she says.

And it’s a good thing she did. Corner went to HealthCore Clinic a couple of weeks later for treatment of a burn that wasn’t healing. They referred her to specialty care, which Corner says she couldn’t afford to pay for on her own. And while her burn was being evaluated, she learned that her blood pressure was too high—and causing retinal damage to her eyes. Her insurance will help her get the care she needs.

But that peace of mind continues to elude a disproportional share of minority Kansans. A recent analysis by the Kansas Health Institute found that 17.4 percent of black Kansans are uninsured, compared to 7.6 percent of whites. That’s a larger gap than in any other state.

Credit Bryan Thompson / Heartland Health Monitor
Heartland Health Monitor
Teresa Lovelady heads HealthCore Clinic, a federally-funded safety net clinic in a predominantly African-American neighborhood in northeast Wichita.

Teresa Lovelady heads HealthCore Clinic, a federally-funded safety net clinic in a predominantly African-American neighborhood in northeast Wichita. She says 88 percent of the clinic's patients live at or below 100 percent of the poverty level, and don't qualify for the insurance marketplace.

By that, she means they don’t make enough money to qualify for federal subsidies to help cover the cost of their premiums. The intent of the Affordable Care Act was for people below the poverty line to be covered by Medicaid. But Gov. Sam Brownback and legislative leaders have blocked efforts to make more low-income adults eligible for the Kansas version of Medicaid known as KanCare.

Lovelady thinks that’s the main reason for the black/white disparity in insurance coverage. And she says the people left without insurance are hard-working Kansans.

“Their income was too low to meet the federal threshold, but they were too rich to qualify for Medicaid in the state of Kansas. And because we did not expand Medicaid in Kansas, it disproportionately impacted the patients that we serve here at HealthCore," she says.

In Kansas, Medicaid doesn’t cover able-bodied, childless adults no matter how poor they are. Brownback and many Republican legislative leaders say the state shouldn’t extend coverage to them while Kansans with disabilities remain on waiting lists, even though those waiting lists are for disability support services—not medical care.

The politics of the issue aside, there is mounting evidence that the states that have rejected Medicaid expansion are lagging behind states that have agreed to the expansion when it comes to reducing the uninsured, and narrowing racial and ethnic gaps in coverage.