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Health & Wealth
KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

Local Organization Takes Up Mantle Of Medicaid Expansion Outreach

children in head start classroom
Photo provided by Missouri Association for Community Action
Central Missouri Community Action typically organizes services including Head Start, but now it is adding Medicaid outreach to its mission.

After a long and fraught process that involved a legislative fight and then a court case, Medicaid expansion is the law of the land in Missouri. State residents who make up to 138 percent of the Federal Poverty Level can qualify for coverage. But when it comes to getting the word out to those who might be newly eligible, state agencies have done very little. Health departments and non-governmental organizations have stepped in to try to pick up the slack. One of those organizations is Central Missouri Community Action. Executive director Darin Preis spoke with the Health & Wealth Desk about his group's efforts.


Darin Preis: Our mission is to empower individuals and families to achieve self-reliance and so traditionally we work with folks with low income, under about 150 percent of the federal poverty level. And so medicaid expansion is for those who are under 138 percent of the poverty level. So it’s folks we’re already working with. We served over 8,000 people last year and probably 95 percent of them would be eligible for the Medicaid expansion. So it’s a group that we’re familiar with and really want to make sure they have access to the information and can get them enrolled.

Health & Wealth: For the folks who you work with, do you get the impression people are aware of Medicaid expansion, or has the delay because of the legislature and the legal fight caused some confusion?

Preis: I think that there has been some confusion for sure, and certainly you know when the legislature refused to fund it and then the court battle and all of the things I think it slipped off of people’s radars. And many folks that we work with really still don’t understand the significance of it and the opportunity to get access to healthcare now. So that’s one of the challenges, just really making sure that people understand how this benefits them and that it’s not some conspiracy to get their information about them. It’s really to help provide preventative and medical services to help improve their overall health.

H&W: Can you tell me a little bit about the folks who you work with and how Medicaid expansion might impact them?

Preis: So typically for a family of four they’re making about $25,000 or around there. They’re typically working, struggling to get by. So they’re struggling to pay their rent or their mortgage, trying to cover the basic needs for their family. And if their employer doesn’t provide healthcare coverage then it’s just really not a priority. They’re trying to do what they’re supposed to do to take care of themselves and their families but the realities of poverty these days are about crisis management. You might be going along fine paying the bills and then something happens and all too often it’s a healthcare issue that happens. You spend one night in the hospital or have to spend time in the emergency room and you don’t have coverage it can be thousands of dollars. They’re just trying to get by and without health insurance it’s just one more opportunity for some crisis to come up in their lives that pulls them back into poverty.

H&W: There's a lot of rural poverty in Missouri and in some of the counties you work in. Are there any obstacles to outreach that are specific to those areas?

Preis: Well, distance for one. That’s certainly one of them. But again, you know what we found from the initial rounds of marketplace insurance and working with that, Washington University did a study and they found the top 3 ways that consumers heard about the application services was through family and friend, no surprise there, community events, and then just the availability of awareness and education materials. So we’ll be sending out information to people that we already are working with, whether that’s through head start or our energy assistance program or maybe we weatherize their home, really getting the word out to them, because they already have a relationship with us and then the idea is we’ll be asking them to promote this among their friends and family