Kansas and Missouri Consumer Health Access Survey

Understanding insurance status, health care access, and medical debt in a regional population

By Anna Sommers Thomas Duffy

The states of Kansas and Missouri are among the 18 states that have opted not to expand Medicaid under the Affordable Care Act. Several foundations that promote a culture of health, help enroll people in health insurance, and support safety-net health care providers in these states shared a sense that people in Kansas and Missouri were struggling with untreated health conditions and burdensome medical bills.

To understand the magnitude of the problem, these foundations chose RTI to conduct a comprehensive survey about consumer health access among residents in the two states. For this survey, our Research Operations Center used the latest software and most effective techniques to call 4,200 Kansas and Missouri consumers and gather clear and meaningful results. We then analyzed the data to gain insights into insurance status and the use of safety-net health services among the target population.

Among the key findings were

  • Roughly one-quarter of adults ages 19 to 64 in both Kansas and Missouri, and one-third of children in both states, live in households carrying medical debt. Those percentages represent almost half-a-million people in Kansas and more than a million in Missouri
  • 20% of adults ages 19 to 64 are uninsured
  • Almost 40% of adults lacked dental coverage, and one in five did not get needed dental care
  • Among the 60% of adults with a chronic condition, such as heart disease or diabetes, 19% in Kansas and 28% in Missouri did not receive care
  • Among the 30% of adults with mental health, substance abuse, or addiction issues, 22% in Kansas and 35% in Missouri did not receive care

These findings add up to widespread hardships among Kansas and Missouri residents, especially low-income people, a category that includes one in four adults ages 19 to 64. The numbers confirm that many people in Kansas and Missouri are dealing with a vicious cycle: a lack of coverage means they delay important treatments for medical and dental issues that worsen or lead to other problems. When they do get care, they often end up struggling to pay the bills.

In June 2018, we announced the findings on the pervasiveness of medical debt, the inaccessibility of dental care, and the lack of care for chronic conditions. The results could prove relevant for policymakers in Kansas, Missouri, and other states as they consider whether to expand Medicaid under the Affordable Care Act.

Based on the results of the Kansas-Missouri study, our clients will be able to focus their outreach and advocacy efforts on specific community needs. The foundations are committed to exceeding their state governments’ efforts to measure access to health care and to gathering scientifically sound evidence to support their future investments. For other states and organizations dedicated to promoting public health, the Kansas and Missouri survey can serve as a model.

Read the Research

Final Report: Results from the 2017 Kansas and Missouri Consumer Health Access Survey

2017 KMHS Fact Sheet

Learn more and view additional research infographics