PERRY COUNTY, MO (KFVS) - Harold McClanahand of Perryville, Missouri fits the description of the working poor. That is, until he got hurt.
"Nobody would hire me," said McClanahand.
About a year ago, he says he was helping his brother-in-law cut down a tree.
"The tree fell, and the wind caught it," said McClanahand. "I saw the tree heading at him. I went under it which I shouldn't have done, jarred me down and pushed it over to the side."
It left him out of work, severely injured and in need of surgery he could not afford.
And, you could say Harold is one of the lucky ones. He has Medicaid.
Right now about 300,000 Missourians reportedly fall into what's known as the "Medicaid Gap."
Gina Harper with the East Missouri Action Agency knows that story all too well. She is a counselor for the Affordable Care Act.
"I hate to tell you, but right now there's no insurance you can afford," said Gina Harper.
That's the message she often has to deliver.
Some don't make enough for coverage under ACA, and some make too much to qualify for government assistance.
For example, Harper says it may be a non-traditional student who has gone back to school and is only bringing home about $10,000 a year. Or, in other cases it's a single mom who can only work so many hours a week.
"Probably 30 percent of individuals I see that come in we need to have that conversation," said Harper.
Medicaid expansion is top of mind in Jefferson City as the legislative session winds down.
Right now about half of the states are expanding Medicaid.
Among them are Illinois, Arkansas, and Kentucky.
Tennessee is not at this time, and Missouri remains up in the air.
"Inaction by the legislature this year is unacceptable," said Democratic Governor Jay Nixon.
Governor Nixon is making his rounds. He is calling on lawmakers to strengthen the Medicaid program.
"It will allow hundreds of thousands of working folks making no more than $27,000 a year for a family of three to get basic health services they need to live healthy, productive lives," said Governor Nixon.
Nixon says Missourians are already paying for it.
"Strengthening Medicaid will protect taxpayers from having their tax dollars spent on healthcare in other states," said Governor Nixon.
Republican State Representative Donna Lichtenegger says that is not true.
"This isn't our tax money, it's borrowed money from China," said Lichtenegger. "People need to know that. I'm not willing to dump a bunch of money into a program that on a federal level is not working."
Lichtenegger says almost 2/3 of the Missouri budget already goes to Medicaid.
She says the federal government would pick up the bill for three years.
"After that, it goes to 90% and we're stuck with the 10% and that many more people."
Former Republican U.S. Senator Kit Bond is now a lobbyist.
He is trying to sway skeptical Republicans.
"We have to get people who were thinking about filibustering,is not to do it,"
Also looking to lend an ear is The Missouri Hospital Association.
The group represents 153 hospitals across the state.
"This is a big problem," said President and CEO Herb Kuhn.
Kuhn says hospitals are cutting jobs and projects while the cost of uncompensated care skyrockets.
"It's an uninsured person every minute of every day coming to a hospital ED (emergency department) seeking care," said Kuhn.
He says southeast Missouri stands to lose the most, as this part of the state has a high number of those who are uninsured.
"What this means, in part of rural areas we're going to see brown outs or in some areas could create medical deserts for certain services across the state," said Kuhn.
For Harold McClanahand, his saving grace came in the form of a generous surgeon.
"He told me I needed it (the surgery) and no matter what I was going to get it," said Harold McClanahand.
The doctor paid for his surgery.
It was a procedure he otherwise could not have afforded.
"I appreciate him very much for that," said McClanahand.
Since Harold's situation is unique, what happens to the rest of the Missourians who fall through the cracks?
Sen. Lichtenegger says job creation is key to closing the gap.
After Heartland News ran promotional material about this story, the Missouri Association for Social Welfare contacted Crystal Britt about this matter.
According to the association, the main objective for the group this year is to have Medicaid Expanded to 135 percent of the poverty level as was called for within ACA.
With the Missouri legislative session wrapping up in mid-May, now is the time to contact your local senators and representatives to let them know how you feel about the matter.