More Americans got health insurance during the pandemic, but not in Kansas | KCUR 89.3

WICHITA, Kansas — Federal pandemic programs that raised health insurance rates nationwide in 2021 ended up not increasing coverage in Kansas — meaning that for the first time in decades, Kansas residents are significantly less likely to have health insurance insurance compared to the US population as a whole.

As millions of Americans lost their jobs, and with it their employer-based health insurance, the federal government introduced sweeping relief measures to help people gain access to coverage. These programs contributed to a significant drop in the rate of uninsured Americans in 2021 to a previous record low of 8.6 percent, according to new data released this week by the Census Bureau.

But the rate of uninsured Kansas residents remained steady between 2019 and 2021 at 9.2 percent. And uninsured rates for people of color in Kansas remain even higher: 14.1% of black Kansas residents lack health insurance, compared to 9.6% in the US as a whole. Of Kansas’ Hispanic population, 20.3 percent are uninsured, compared to 17.7 percent for the U.S. as a whole.

One reason insurance rates are lower in Kansas is the state’s failure to expand Medicaid eligibility under the Affordable Care Act. As of 2021, 36 states and the District of Columbia have expanded Medicaid. Gains in insurance coverage were higher on average in these locations.

The new data suggests that the pandemic programs did help many Kansas residents get or keep health insurance coverage, even if they didn’t ultimately lead to an increase in overall insurance rates. Public health insurance coverage in the state swelled 1.5 percent, a similar rate to the U.S. as a whole, likely thanks to a provision which prevented states from kicking most people off Medicaid during the pandemic.

“Providing continuous Medicaid coverage led to increases in Medicaid that very likely prevented the increase in the uninsured rate in Kansas,” said Gideon Lukens, director of health policy research and data analysis at the Center on Budget and Policy Priorities.

But these gains were offset by a significant decline in private health insurance coverage. Kansas saw a 1.7 percent decline in private coverage, more than four times the national rate of decline.

This decline can be largely attributed to a decline in employment-based health insurance. There was a small but not statistically significant increase in the percentage of Kansas residents who purchased health insurance directly, including from the state’s health marketplace. America’s bailout make this insurance cheaper for people with low and middle incomes.

Philip Steiner, a senior analyst at the Kansas Health Institute, said there are several reasons people could lose employment-based coverage.

“It could be people changing jobs or choosing to work without coverage, or people leaving the workforce,” he said. “But people may also opt out of their employer-sponsored plans that they have available.” We’re seeing premiums go up pretty steadily in Kansas.”

The institute receives funding from the Kansas Health Foundation, which funds the Kansas News Service.

The Census Bureau said a decline across the country in employment-based health insurance partly stems from an increase in people working in jobs that are less likely to offer health insurance, such as food service and construction. The bureau will release state-level data on the issue next month, but a similar story could play out in Kansas.

After the federally declared public health emergency and continued Medicaid coverage ends — which could happen as soon as October — the federal government predicts 15 million Americans will lose their health insurance, including an estimated 5 million children.

Some will have access to Marketplace subsidies and other insurance options. But an estimated 383,000 people living in Kansas and the 11 other states that have not expanded Medicaid will have no other affordable coverage option. That’s because they fall into the coverage gap that exists in non-expansion states: They make too much money to qualify for Medicaid, but not enough money to qualify for Marketplace tax credits that would buying your own insurance affordable.

“A large part of the number [of Kansans] who remain enrolled are likely to fall into that gap,” Steiner said.

Lukens said the process of ending the COVID-19 coverage provisions, called “unwinding,” could leave Kansasns with even fewer insured than before the pandemic.

“It’s really important that states take steps now to prevent things like administrative errors that prevent people who are still eligible from being disenrolled, as well as help people who lose their Medicaid coverage, to switch to another coverage,” he said.

Medicaid expansion is a contentious issue in the Kansas State House. Democrats support it, but the Republican leaders of both chambers have opposed the idea.

“There is still an opportunity for Kansas to expand [Medicaid] to more than offset any drop in coverage that might occur during unwinding,” Lukens said.

Rose Conlon reports on health for KMUW and the Kansas News Service. You can follow her on Twitter at @rosebconlon or email her at [email protected]

The Kansas News Service is a collaboration between KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focusing on health, the social determinants of health and their relationship to public policy.

Copyright 2022 KMUW | NPR for Wichita. To see more, visit KMUW | NPR for Wichita.

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