Thousands of Kansans still lack health insurance, making them less likely to get the care they need, putting them at risk of accumulating medical debt, and straining rural health care providers. The number of uninsured in our state also includes nearly 38,000 Kansas children.

Two in three of those children are probably eligible for Medicaid but not enrolled, according to a new analysis from the Kansas Health Institute, a nonprofit research organization based in Topeka.

Medicaid, also called KanCare in Kansas, is a critical part of children’s health care access in the state. The program provides health coverage for families living at or near the poverty line. In 2017, 37.5 percent of Kansas children were enrolled in KanCare. The program covers 39 percent of all births in the state.

However, thousands of Kansans make too much to qualify for Medicaid but not enough to afford private health insurance. These families, caught in a coverage gap, would be covered under Medicaid expansion. We have fully endorsed Medicaid expansion as a commonsense strategy for helping low-income, working Kansans afford health care and offering a much-needed cash infusion to our struggling rural hospitals. However, the new data on children not enrolled in the program points to a more insidious problem likely not solved by expansion alone.

Although about half of the children eligible for Medicaid but not enrolled live in the most populous counties in the state, many of the highest rates are found in rural counties. In Sheridan County, 23.4 percent, or nearly one of four children, who are likely eligible for Kancare are not enrolled, the highest rate in the state of Kansas.

Why would someone who is eligible for Medicaid fail to enroll in the program? An Urban Institute analysis identified time, hassle, stigma and lack of knowledge as possible barriers to enrollment. Many Kansans may not know they qualify, or may struggle to afford health care expenses even with KanCare. Some families may have experienced bureaucratic hurdles they were not equipped to overcome during enrollment backlogs of the past decade.

Transient families or those with concerns about accessing government support may also be less likely to enroll.

Being uninsured places children, in particular, at significant risk. Uninsured children are more likely to have unmet health care needs and less likely to have a primary care doctor, get preventative care and see a dentist.

As a state, we must do more to reach children in need of health care coverage. Advertising and outreach to spread the word about Medicaid are important. Communication between social service providers can help identify those families most at risk for falling through the cracks.

Ultimately, families eligible for the program must know KanCare enrollment can help their children get the care they need. When it’s difficult to make ends meet, getting a hand by applying for Medicaid is a wise financial decision for any family who qualifies for the service. As a state, Kansans must make sure all of our children have the best possible care.