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Wednesday, April 29, 2015

Medicaid Expansion in Kentucky: Anthony’s Story

Dee Mahan

On April 29, Families USA released a report that profiles two residents in neighboring states: Iowa, which chose to accept federal funds to extend health coverage to more adults through Medicaid, and Missouri, which has rejected federal funds to do the same. Our report shows how a state’s choice to extend health coverage can make a real difference in people’s lives. It also shows that if a state chooses not to extend coverage, that choice is not only a great injustice—it threatens access to care for Americans who need affordable, quality health care. 

In January 2014, Kentucky extended Medicaid coverage to all adults with incomes under 138 percent of poverty ($27,724 for a family of three). For the first time in 30 years, Anthony Stollings, a 60-year-old resident of Florence, Kentucky, was able to get health insurance.

Stollings, a professional roofer, had health insurance through his employer at the start of his career. But after he fell off a roof, he lost his job. He was still able to work, and he found roofing jobs at other construction companies, but none offered health insurance. He couldn’t afford private health insurance, nor was he eligible for Medicaid because he didn’t meet Kentucky’s eligibility rules. 

Before January 2014, Kentucky’s Medicaid program covered non-disabled adults only if they had dependent children and made less than 57 percent of poverty—an annual income of just $11,450 for a family of three. Adults without dependent children were not eligible at all. 

Without health coverage, residents often fear the costs associated with needed doctor visits 

Until a few years ago, Anthony had been fortunate enough to have relatively few health problems. Any problems he did have, he said he just had to “live through it” because he couldn’t afford to see a doctor. That included popping a dislocated shoulder back into place himself. But a few years ago, his luck changed. 

Anthony started having blackouts. On one occasion, he blacked out while he was in the local library, and the librarian called an ambulance. By the time the ambulance arrived, he had regained consciousness and turned it away because he was afraid he wouldn’t be able to afford an emergency room visit. 

In addition to blackouts, Anthony noticed that his eyesight was failing. At that time, he was enrolled in a program to get a bachelor’s degree in business and marketing, but his eye problems made it hard for him to read, so he had to drop out. 

When Kentucky extended coverage in 2014, Anthony got health insurance for the first time in decades. He finally went to see a doctor and found out he has diabetes, which probably explains the blackouts, failing vision, high blood pressure, and kidney damage for which he has been diagnosed. 

Without health coverage, too many go untreated, including those with diabetes—the leading cause of disability in the U.S.

Overall, Anthony is lucky: Because he lives in a state that extended health coverage, he’s been able to get treatment and learn to manage his diabetes before it further damaged his health. He’s among many who have been able to get treatment because they live in a state that extended Medicaid

Anthony’s eyesight has improved, and he hopes to finish his degree. He is also an artist, and his painting "Working People" is on display in this year's Governor's Derby Exhibit, which you can see in the state's Capitol Rotunda from March 30 through May 4. 

But if Anthony lived in a state that had not extended Medicaid—like next door in Missouri—his story would be very different. His diabetes would have continued unchecked, causing more damage to his kidneys and eyes and probably damaging other organs as well. He would likely have developed expensive complications. He may have eventually qualified for Medicaid, but for a very different reason—because of a disability. Diabetes is one of the leading causes of disability in the United States

Medicaid expansion leads to better quality of life for more residents

Expanding Medicaid has given hope to hard-working people like Anthony—people who are trying to make their lives better. 

“Having health insurance has given me the opportunity to bring my health up,” said Anthony. “I want to be around for my children and set an example for them.”

Better health can mean better opportunities. Missouri and the 20 other states that have not extended health coverage are not just rejecting federal funds to pay for health insurance for their residents—they are rejecting a chance to give their residents better opportunities in life. Lawmakers in those states can change that. At any time, lawmakers can accept the federal funds available to extend health coverage and improve residents’ lives.