Providing leadership, advocacy, and resource to eliminate barriers and promote quality health for the uninsured and underserved in our service area.
When I dismantle HCF’s mission into its bits and pieces, the action words stand out loud and clear: “leadership, advocacy, and resources,” but perhaps more importantly I think about the who of this Foundation. Who are we here to help and how? We exist to serve the uninsured and underserved.
HCF’s founders could have explained this population in countless ways, “low-income,” “poor,” “needy,” “at-risk,” but the word that stuck was uninsured. This is because insurance status is one of the most powerful predictors of health outcomes. People without health insurance are more likely to delay needed treatment, receive late-stage diagnoses, have unmanaged chronic diseases, and receive poor quality care. Therefore HCF has consistently prioritized access to care in both our grantmaking and policy advocacy.
Our 2018/2019 policy agenda continues our advocacy in support of maintained and expanded access to health coverage for those who are uninsured. The political tumult in Washington DC surrounding ACA repeal and replace efforts (see here, here, here, and here) has certainly elevated a national political dialogue about how we structure and fund our nation’s health care system.
I have no crystal ball to foretell where these conversations will go, but I am confident that HCF will be at the table, ensuring that the health of the uninsured is protected. Here are just a few of the specifics we will be watching in the coming years around access to coverage:
- The Kansas legislature passed KanCare expansion in the 2017 legislative session, but the bill was vetoed by Governor Sam Brownback. The legislature was just a few votes shy of overriding the Governor’s veto. We will support advocacy to expand KanCare once again.
- Many of the federal ACA repeal/replace efforts included policies that would block grant the Medicaid program, ultimately reducing in decreased funding to states. We are watching both Kansas and Missouri to guard against block grant proposals that threaten access to care for our most vulnerable. We will also ensure that the KC federal delegation understands how such proposals would impact our community.
- The Affordable Care Act, while far from perfect, has resulted in substantial declines in the number of people in our community who are uninsured. The number of uninsured people in Kansas and Missouri has decreased by nearly 300,000 since the ACA passed in 2009. HCF appeals to our elected leaders to preserve what has worked about the ACA and improve upon what hasn’t.
- Maine’s recent Medicaid expansion via ballot initiative prompts questions about whether such a proposal would be supported in Missouri. Although Kansas law doesn’t allow for such citizen initiatives, the door is open in Missouri. If both Missouri and Kansas expand Medicaid, there will be 700,000 fewer people who are uninsured. This would bring approximately $325 million into our six-county service area each year in support of health access for our neediest residents.
- We will be vigilant to defend and maintain existing coverage. Budgets are tight and Medicaid is under siege; still, this is not a time for backtracking on hard-fought gains, such as the Children’s Health Insurance Program and adult dental Medicaid benefits.
- Finally, we are eager to advance some of the incremental access improvements recommended in our research on a “Pathway to a Reformed and Expanded MOHealthNet System.”
The beginning of a new year is always a time to set priorities with renewed vigor. We at HCF are excited to start another year of providing leadership, advocacy and resources so we can continue toward a culture of health that includes everyone, especially the uninsured and underserved.