‘Sorry, you don’t qualify’: Many Missourians can’t access affordable health coverage

El Centro staff during an enrollment planning session

How I dread having to utter the words, “Sorry, you don’t qualify.”

Every year, as we assist hard-working families to sign up for Medicaid or the insurance marketplace, this is a phase we have to use often. 

Worst yet is when we explain to someone that their income is too low to qualify for marketplace credit, but according to state income guidelines their income is too much for Medicaid. Their eyes instantly grow twice as large, trying to process the news. 

This is exactly what happened when I tried to help our client, Rosa, sign up for a health insurance plan through the marketplace exchange. After processing what I’d told her, Rosa asked, “So I’m too poor for the marketplace but too rich for Medicaid?” 

Rosa is a single mother working 30 hours a week as a home health aide. She dreams of being a nurse but is unable to afford to take classes while she works to support her 3-year-old. She dedicates her life to caring for others’ health care needs but is unable to get health care of her own. 

Medicaid has such limiting income guidelines in Missouri that Rosa would have to fall below 22 percent of the federal poverty level to qualify, which is less than $3,720 annually for a family of two. At this point, Medicaid expansion in Missouri is Rosa’s only hope for being able to afford health insurance. 

Currently, about 113,000 Missourians find themselves in the same situation as Rosa, falling “in the gap,” as it is known. Approximately 230,000 Missourians would gain health insurance if Medicaid is expanded after the August election. This is something that could immediately and positively improve the quality of life and access to health care services for many.

Take Maria, for another example. Our client found herself in an unexpected situation a couple of years ago when her husband died. As a young widow with three children, she has supported her kids with a couple of part-time jobs, but does not have access to employer-based insurance coverage. As I spoke with her, she talked about how lucky she felt that her children all had Medicaid, they were all up on their vaccines, and had their yearly physicals and checkups whenever they got ill.

When I asked about the last time she’d been to the doctor or had a well-women checkup, she just shrugged her shoulders and said, “Desde que se murió mi marido,” — since my husband died. Maria shouldn’t have to sacrifice her health or depend on the overextended safety net clinics to get preventive care. 

Working at El Centro, a welcoming center for Latino families, we know the importance of helping individuals with understanding and accessing the resources and services they need. Our mission is to strengthen communities and improve the lives of Latinos and others through educational, social, and economic opportunities. 

The services and opportunities we offer help reduce the disparities and remove the barriers that have caused gaps in services for those we serve. We work hard every day to not only provide services but, more importantly, advocate, educate, and dispel myths that can harm our communities. Our programs build educated, healthy, and financially stable Latino families not just for this generation, but for generations to come. 

Health disparity and negative health outcomes disproportionately harm low-income, black, brown, and immigrant communities. Access to health insurance coverage is the best opportunity we have to improve health and create a more equitable health care system for all.

Missouri needs to expand Medicaid now so women like Rosa and Maria can care for themselves, as well as they care for others. Vote YES on 2 on August 4th to help all Missourians achieve better health.

Erica Andrade has had experience as a health navigator for more than 10 years.

Health Reform, Policy

Health Forward Foundation
2300 Main Street, Suite 304
Kansas City, MO 64108
(816) 241-7006