A navigator is an individual trained to help consumers as they look for health insurance, including coverage options and completing the paperwork necessary to enroll in coverage. Health care navigators are unbiased and their services are free to consumers.
FROM A NAVIGATOR IN KANSAS:
A single mom with four children came in to see what options she might have for health insurance coverage. She hadn’t had health insurance for several years and knew that she needed assistance to find affordable health coverage.
All four children qualify for the Children’s Health Insurance Program (CHIP), but mom still hadn’t been able to figure out coverage for herself. She hoped a navigator would be able to help.
She filled out an application for the Health Insurance Marketplace, hoping to get financial assistance or find something affordable. At the end of the application, though, it was clear: she was left without any affordable options. She made too much to qualify for the state’s Medicaid program, KanCare, but too little to get financial assistance on the Marketplace. The full premiums for even the lowest plan were unaffordable.
Though it seems illogical, there are thousands of Kansans in the same situation as this single mother. Because of a ruling by the Supreme Court in 2013, Medicaid expansion became an optional part of the Affordable Care Act for states, leaving a gap in coverage. This means that there are thousands of Kansans who are too low-income to qualify for help paying for health insurance.
This mom makes too much to qualify for KanCare, which has extremely strict eligibility limits. In Kansas, a single parent with 2 children won’t qualify for KanCare if they make more than about $9,500 per year. Financial assistance on the Marketplace starts at about $25,000 per year.
In order to get access to affordable health insurance, this mom would need to change her financial situation, but that isn’t an option right now. She left the appointment feeling incredibly discouraged and said she will have to find a way to make it work without health insurance.
She is just one of thousands of Kansans caught in the health insurance coverage gap. Expanding KanCare is the simplest way that Kansas can close the coverage gap, giving access to affordable health insurance to 150,000 people and improving the health of all Kansans.
Do you know someone who recently lost KanCare coverage due to the re-starting of KanCare renewals? Are you living in the coverage gap without health insurance and want to tell your story? Email Marissa Alcantar at email@example.com.