Medicaid keeps adults healthy and employed

By Suzanne Wikle

Many people get health insurance through their jobs, but for those who work in food service, retail or child care, the chances are high that their jobs don’t offer health insurance. In Kansas, very low-income parents and their children may receive health care coverage from KanCare, our name for Medicaid. But parents who earn a little more—and all workers without dependent children—fall into the “coverage gap” and can’t get coverage.

As a social worker who has worked as an advocate to reduce poverty and increase access to health care for a decade, including seven years in Kansas, it’s clear to me that issues of people who live in poverty are complex. There is no single solution to helping people escape poverty, but we do know that providing supports that allow people to obtain and keep employment is a core component to attaining economic security. That is why it is encouraging to see Kansas consider House Bill 2064, establishing the KanCare Bridge to a Healthy Kansas program, which would expand health care coverage through Medicaid to an estimated 150,000 more low-income Kansans.

Medicaid serves as a critical work support program, allowing adults to remain healthy enough to stay employed and improving enrollees’ health so they can become successfully employed. For parents, expanding Medicaid removes the “cliff effect” that they experience when their earnings increase above the current Medicaid limit, but are too low to qualify for subsidized insurance through the Affordable Care Act’s Marketplace Exchange.

In 2014, Ohio expanded Medicaid, as have 31 other states. A recent comprehensive report from the Ohio Department of Medicaid on that expansion underscores the importance of Medicaid as a program that supports work. It finds employment stability is one of several benefits to the people who became eligible for Medicaid after the expansion. In fact, more than half of Medicaid expansion enrollees report that Medicaid has made it easier to secure and maintain employment.

The majority of Kansans in the coverage gap are working, but health concerns are a threat to the stability of that employment. Without access to affordable health care, those who become ill or have chronic conditions find it harder to maintain employment. Medicaid expansion provides affordable access to care, allowing people to stay healthy enough to remain in the workforce.

Those in the coverage gap who are unemployed are likely facing significant health issues that limit their ability to search for or maintain employment. Only once they are healthy will they be able to focus on employment.

A report from the conservative American Enterprise Institute in July 2016 found that illness or disability are the top reasons why poor people, particularly adults without children, are not working. Authors of the AEI report argue that there must be policies that focus on improving the health of the poor in order to support employment.

HB 2064 is exactly the type of policy that will support those who are too ill to seek work by allowing their health concerns to be managed, which in turn positions them to focus on employment. It is a win-win for Kansas.

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