Kathleen Christian is a remarkably healthy 63-year-old. She has no chronic conditions and rarely sees the doctor for anything other than preventive care.
Even so, she said she had been looking forward to getting health insurance under the Affordable Care Act, after having been without coverage since she was laid off in 2009.
But last month, Christian learned she would not be able to get coverage after all.
Because Kansas has not expanded Medicaid eligibility under the ACA, she is one of an estimated 85,000 uninsured Kansans who experts predict will fall into the so-called "Medicaid coverage gap."
Christian is not eligible for Medicaid (also known as KanCare in Kansas) because she earns too much to qualify for it but she is too poor to qualify for the ACA’s federal tax credits to buy private insurance.
Without the subsidies, there is simply no way she could afford $384 each month for the cheapest plan on HealthCare.gov, Christian said.
"Where am I supposed to get $384 every month? I budget and keep a spreadsheet. I know where every penny goes," Christian said.
Her 2012 adjusted gross income from part-time work was $5,008 and her monthly Social Security checks are about $800, she said.
"The last day of (November), I had $2.96 to my name. By the grace of God, every time I run out, usually the next day I have something to work with," she said. "I'm not alone. I know lots of people like me, lots of people who are struggling. There's just no way they can pay these premiums. It's just not realistic."
Christian said she lays equal blame on President Obama and Gov. Sam Brownback, who has opposed provisions of the ACA from the beginning.
"They're just a bunch of boys having an argument about who's better than who. It's all a political game for them. I don't think they're really seeing what they're doing to people," Christian said. "I guess people who have money just don't understand what being poor is. I'm not materialistically poor — I have a roof over my head, thank God, and we have enough food, although we could use a little bit more. We're not starving to death. But we're cash poor. That's just the way it is."
Christian said when she found out she'd be in the coverage gap, she wrote a letter to Brownback expressing her frustration:
She was laid off from her long-time job at a Lawrence home security company during the recession, she said.
Apart from a minimum wage job capped at 18 hours a week and the occasional temp job, she’s been out of work for four years.
"I'm in my sixties. It's not real easy to get a job," Christian said.
She has custody of her 13-year-old grandson and gets $115 per month in food stamps.
"It was $135, until they cut it back," she said.
When push came to shove, she filed for early retirement to get the Social Security payments, a move that means she gets lower monthly payments than if she had waited longer to take retirement.
"It was the only way I could support us. I didn't want to do early retirement, but I had no choice," she said.
Her grandson is covered by KanCare, which has less restrictive income requirements for children and pregnant women, but she has no health insurance. She pays for her dental cleanings every six months out of pocket.
"At this point, I'm just biding my time until I can get Medicare," she said.
Nearly 182,000 Kansans in the ‘Eligibility Gap’
Christian said she wrote to Brownback hoping a personal story might "get through to him."
“I told him that, as far as I'm concerned, the state of Kansas should be paying the premium credits for those people who do not qualify. I told him that maybe $384 is chump change to him and his people, but it's a lot of money for me,” she said.
Brownback spokesperson Sara Belfry acknowledged receipt of Christian’s letter.
“We did receive a letter from Kathleen (and), like all other correspondence we receive from constituents, we sent a response,” Belfry wrote in an email. “Beyond that, I have no further comment.”
Christian said that, as of this evening, she had yet to receive a response.
KHI News Service coverage of Medicaid expansion→ Medicaid Access Coalition launches online "ticker" showing foregone federal dollars (2/13/14)
→ KHI report: Nearly 182,000 Kansans in the ‘Eligibility Gap’ (1/11/14)
→ House speaker says Medicaid expansion is "up to the governor" (1/10/14)
→ KS Senate president says Medicaid expansion unlikely to gain approval this session (1/7/14)
→ Profiles of the coverage gap: Kathleen Christian (1/6/14)
→ Efforts continue to expand Medicaid in Kansas and Missouri (1/6/14)
→ Hospital association hires former Bush HHS secretary to help craft a plan Kansas Republicans might support (12/23/13)
→ Iowa wins approval to expand Medicaid by using federal funds to buy private insurance (12/11/13)
→ White House officials hold call to urge Medicaid expansion in Kansas (11/21/13)
→ Republican governor talks up plan to expand Medicaid — his way (10/28/13)
→ Challenger says Brownback owes voters a decision on Medicaid expansion (10/22/13)
→ Nearly 5.2M Americans fall in coverage gap in states not expanding Medicaid (10/16/13)
→ Sebelius: Feds flexible on how states expand Medicaid (9/22/13)
→ Sebelius says Kansas and Missouri are missing the boat on Medicaid expansion (9/20/13)
→ Medicaid expansion coalition finds strength in numbers (9/17/13)
→ Republican Gov. Corbett proposes expanding Pennsylvania Medicaid (9/16/13)
→ Kansas lawmakers urged to consider Medicaid expansion by Wesley CEO (8/29/13)
→ Estimating maneuver could help more people gain from Obamacare: How the poor might qualify for Affordable Care Act subsidies in states that don't expand Medicaid (8/12/13)
→ Report: States not expanding Medicaid stand to benefit most from doing so (7/18/13)
→ CMS won’t penalize hospitals in states slow to expand Medicaid (5/14/13)
→ Insurer Centene: We can do Arkansas-style Medicaid (5/14/13)
→ The Arkansas Medicaid Model: What you need to know about the 'private option' (5/2/13)
→ Nothing to be done about coverage gap in states not expanding Medicaid, feds say (4/29/13)
→ Brownback says he's listening to Medicaid expansion proponents, opponents (4/5/13)
→ Oregon shows costs of putting Medicaid enrollees in private coverage (3/29/13)
→ Governor urged to expand Medicaid eligibility (3/27/13)
→ Arkansas Medicaid expansion attracts other states' interest (3/26/13)
→ Senate president prefers options remain open on Medicaid expansion (3/25/13)
→ States urged to expand Medicaid with private insurance (3/22/13)
→ Senate budget amendment underscores opposition to Medicaid expansion (3/21/13)
→ Study: Kansas employers face millions a year in possible penalties without Medicaid expansion (3/15/13)
→ More than 30 Kansas groups pushing for Medicaid expansion (3/12/13)
→ Health insurers see big opportunities in health law’s Medicaid expansion (3/8/13)
→ Medicaid expansion supporters to step up lobbying efforts (3/7/13)
→ Budget committee hears resolution opposing Medicaid expansion (2/22/13)
→ Legislators focusing on Medicaid expansion cost estimates (2/19/13)
→ Kansas hospital group study predicts expanding Medicaid would generate 4,000 jobs (2/18/13)
→ Brownback officials release their cost projections for Medicaid expansion (2/8/13)
→ Medicaid expansion bill introduced (1/22/13)
→ Kansas hospitals worried about loss of dollars for charity care (1/14/13)
→ Brownback compiling own estimate of Medicaid expansion cost (12/20/12)
→ Group urges Brownback to expand Medicaid eligibility (11/9/12)
→ Debate begins on possible Kansas Medicaid expansion (10/25/12)
→ Amerigroup CEO says states ‘need’ to go along with Medicaid expansion (7/11/12)
→ Kansas hospitals ready to get on with federal health reform, spokesman says (7/2/12)
→ Kansas AG claims partial victory in health reform case (6/29/12)
→ High court upholds Affordable Care Act, but ruling puts limits on Medicaid expansion (6/28/12)
→ Kansas Hospital Association: An opportunity for the Kansas Medicaid program
→ Americans for Prosperity-Kansas: Well-intentioned policies do more harm than good
→ Health Reform Resource Project: The cost of not expanding Medicaid
→ Rep. Jim Ward: Medicaid expansion essential for healthier Kansas
→ Rep. David Crum: Reasons for opposing Medicaid expansion
→ National Academy for State Health Policy: Much ado about Arkansas: Medicaid in the insurance exchange
→ Full health reform coverage
→ Full Medicaid coverage
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