affordable care act

House Republicans on Friday followed through on a threat to sue President Obama over actions he has taken concerning the Affordable Care Act.

The lawsuit was filed in a federal court against the Department of Health and Human Services and the Department of Treasury.

On a recent afternoon at his office in Hartford, Conn., Dr. Doug Gerard examines a patient complaining of joint pain. He checks her out, asks her a few questions about her symptoms and then orders a few tests before sending her on her way.

For a typical quick visit like this, Gerard could get reimbursed $100 or more from a private insurer. For the same visit, Medicare pays less — about $80. And now, with the new private plans under the Affordable Care Act, Gerard says he would get something in between, but closer to the lower Medicare rates.

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Almost 800,000 uninsured Missourians became eligible for coverage through the federal health insurance marketplace earlier this year. As the state continues to consider extending coverage to even more individuals through Medicaid expansion, the need for primary care doctors will increase as well.

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The federal government agency that oversees applications for health insurance under the Affordable Care Act says that the computer problems which plagued early sign-ups are to blame for problems at a suburban St. Louis processing center.

David Sachs / SEIU

  

  By now Missourians are familiar with the debate over expanding Medicaid in the state.

The Affordable Care Act gives most people the opportunity to purchase health insurance with help from federal tax credits. But individuals earning too little to qualify for these tax credits but too much to be covered under for Missouri Medicaid are stuck in what is called “The Gap.”

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The US Department of Health and Human Services released data Thursday showing that 152,335 Missourians are enrolled in health insurance marketplace plans. The number of enrollees more than doubled in March alone, the total exceeding the federal goal by 29 percent.

Data also showed, however, that 300,000 people in the state are unable to get insurance due to ineligibility for Medicaid or financial help in the marketplace.

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A new report says more than 150,000 Missouri residents signed up for health insurance policies through a federally run website.

Véronique LaCapra / St. Louis Public Radio

 

For years in most states, Medicaid eligibility had been limited to disabled adults, seniors needing long-term care and very low-income parents with their children.

Then along came the Affordable Care Act. It was designed to grow health insurance coverage across the board. One of its tenets was to expand Medicaid coverage beyond the extremely poor and disabled to include all adults earning up to 138 percent of federal poverty levels.

But in 2012, the Supreme Court gave states the chance to opt out Medicaid expansion.

Illinois is one of 25 states that went ahead with expanding the program. Neighboring Missouri did not.

We looked into the impacts of those differing decisions. Here’s what we found out.

Katie Hiler / KBIA

  

We’ve been hearing a lot about the Affordable Care Act from a number of politicians - Governor Jay Nixon, Senator Roy Blunt, and, of course, President Obama, to name a few.  These people can talk about the number of people insured and weigh the cost versus economic impact. But behind those numbers they’re citing are people, Missourians. Those dollar figures they throw around, that’s money in and out of our pockets. So how do Missourians who have been trying to utilize the new healthcare law feel about it? 

The Obama administration says it will give people more time to sign up for health insurance through the federal online marketplace.

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Jacob Fenston / KBIA

Several Republican state senators are making it clear that there will be no expansion of Medicaid eligibility this year in Missouri.

Five GOP senators took to the Senate floor Monday as the Legislature returned from spring break to say they will block any attempt to expand Medicaid eligibility during the session that ends in mid-May.

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An associate professor at the University of Missouri School of Law is involved in a case that goes before the U.S. Supreme Court this week.

Josh Hawley is on a team of about 15 lawyers working on Sebelius v. Hobby Lobby Inc. The case addresses whether businesses can use religious objections to avoid a requirement to provide insurance coverage for birth control for employees.

Katie Hiler / KBIA

The Affordable Care Act’s online health insurance marketplace has been open for business since October 1 and technical issues that plagued the website early on have mostly been resolved. Yet Missouri residents have been slow to sign-up for health insurance under the new law. According to the nonprofit group Kaiser Family Foundation, only 40 percent of Missourians eligible to enroll have actually chosen a plan. I spoke with U.S. Secretary of Agriculture Tom Vilsack about why signing up is important for Missouri residents, particularly in rural areas.  

A report issued Tuesday by the federal Department of Health and Human Services found that almost 200,000 Latinos in Missouri may have new options for health coverage. The report says they might qualify for Medicaid or the Children’s Health Insurance Program, or for lower costs on premiums  through the Health Insurance Marketplace. 43,000 of the eligible Missouri Latinos are currently uninsured, the report says.

Aaron Swaney, outreach and enrollment specialist at the Family Health Center, said the center does have a sizable portion of patients who are uninsured and Latino.

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File Photo / KBIA

Gov. Jay Nixon is reiterating his push for Medicaid reform, saying expanding the program would cover the 50,000 currently uninsured Missourians who need mental health services.

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At his sixth State of the State address Tuesday, Gov. Jay Nixon renewed his push to expand Medicaid, the health insurance program for the low-income population, in Missouri. He was careful, though, not to mention the “e” word itself. Instead, the governor called lawmakers to work on reforming the program.

“I look forward to working with all of you to bring affordable health coverage to working families in Missouri, and reform Medicaid the Missouri way,” said Nixon.

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This Monday marks another big deadline under the Affordable Care Act. That's the last day that people can sign up for insurance through the online marketplace and have their coverage begin on January 1.

Harum Helmy / KBIA News

    

On an afternoon in early December, 60-year-old Columbia resident Jeannie Wyble sits in a small cubicle at Columbia’s Family Health Center, telling Aaron Swaney, a HealthCare.gov application counselor, about the heart attack she suffered in 2002.

“I quit smoking when I had my heart attack,” Wyble said. “Smoked my last cigarette on the way to the ER, never smoked another one.”

At the time, Wyble was still insured through her husband’s union plan. But after the heart attack, the insurance company began increasing her monthly premium. Wyble says at one point, she had to pay almost $500 a month.

“And then when we found out they were going to jump even more again the following January,” Wyble said. “It was very clear to us that we couldn’t pay my premiums anymore and that mine would just have to be dropped. In effect, [the insurance company] decided to get rid of me, and it worked. They did. They got rid of me.”

Harum Helmy / KBIA

Consumers who want to sign up for health insurance under the Affordable Care Act have until Monday to enroll in a plan that would start on Jan. 1. But HealthCare.gov still has kinks that frustrate many consumers and navigators. KBIA’s Harum Helmy followed one Columbia resident’s journey with the website. 

Alan Cleaver / flickr

 

As an Affordable Care Act navigator, Kate King has been traveling to counties throughout central Missouri spreading awareness of and getting Missourians enrolled in HealthCare.gov.  

King works with the Central Missouri Area Agency on Aging, which serves a 19-county area, 17 of them rural. The agency is part of a nonprofit alliance that received $750,000 in federal grants in August to help with Healthcare.gov outreach. 

 

Compiled by Kelsey Proud, St. Louis Public Radio / Flickr

The U.S. Department of Health and Human Services reports 4,124 Missouri residents have selected a health insurance plan through the federally run online marketplace healthcare.gov.

The department released the figures Wednesday. HHS said the insurance exchange had more than 31,000 applications from Missouri through Nov. 30. The applications sought coverage for nearly 63,000 people.

Some health care advocates are suing the state of Missouri over legal limits on the counselors enlisted to help consumers navigate the new online health insurance marketplace.

A new Missouri law requires insurance counselors to get state licenses to help online shoppers negotiate the federal insurance exchange. Missouri's Republican-led Legislature opted against setting up a state-run exchange.

If you're a 38-year-old Missourian living in Pemiscot County in the Bootheel, an Affordable Care Act "gold" insurance plan will cost you at least $418 per month, before subsidies. If you're a 38-year-old living in Kansas City, a similar plan will cost you about $263 per month. 

Here's why:

missouri capitol
Jacob Fenston / KBIA

Health insurers serving the individual and small group markets in Missouri can continue selling plans that would have been canceled by Dec. 31 for not meeting the requirements outlined in the Affordable Care Act, according to the state's Department of Insurance. 

Starting in 2014, all health insurance plans must include some services from all of the law's "10 essential health benefit" categories. The broadly defined categories include, among others: maternity care, behavioral health treatments, prescription drugs, laboratory services and preventive services.

Insurance companies have now sent cancelation notices to millions of Americans who hold health plans that did not meet those requirements.  Following nationwide criticism, President Barack Obama proposed on Nov. 15 that the administration would allow the canceled plans to remain effective until the end of 2014.

Alan Cleaver / flickr

Out of nearly 28,000 Missourians who have completed the applications for insurance through HealthCare.gov, only 751 so far have chosen insurance plans. The online marketplace, a key part of the Affordable Care Act, opened for enrollment on Oct. 1. Technological glitches made signing up nearly impossible in its first couple of weeks. 

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Flickr / steakpinball

A federal judge has thrown out a Missouri lawmaker's lawsuit seeking an exemption from contraceptive coverage under the new Affordable Care Act's insurance provisions.

Alan Cleaver / flickr

As the Affordable Care Act's provisions continue to roll out, the law will continue to affect our lives.

In Missouri, where the legislature still hasn't expanded Medicaid, 193,000 adults will fall in what’s called the “coverage gap.” These adults aren’t eligible for Missouri’s current Medicaid program (which doesn’t cover any able-bodied adult without children, no matter how low his or her income), and they make too little money to qualify for any subsidies that can help them pay for insurance premiums through the online health marketplace.

Despite the gap, a national report says 40 percent of the 800,000 in Missouri who are uninsured could be eligible for free insurance premiums through HealthCare.gov. That is, of course, if the website would just function properly.

Meanwhile, some people are also getting kicked out of their existing insurance plans -- some of which have been canceled for not meeting the basic coverage to be a Qualified Health Plan under the Affordable Care Act.

KBIA needs your help in personalizing the stories mentioned above. Would you share with us your experience with the Affordable Care Act? Fill out the form below. We won’t publish your name or story without your permission.

Hat tip to ProPublica, who published the original version of this form. 

McCaskill: Public will eventually like health law

Oct 31, 2013
claire mccaskill
studio08denver / flickr

Sen. Claire McCaskill says she's "embarrassed and angry" about the rollout of a key part of the new federal health care law. But the Missouri Democrat believes people will eventually come to like it.

Alan Cleaver / flickr

The Affordable Care Act’s online insurance marketplace has its problems, but the service also has potential to help improve rural health. Jon M. Bailey, the director of rural research and analysis at the Center for Rural Affairs, went as far as putting it this way:

“The new health insurance marketplaces were practically created for rural people.”

Calsidyrose / Flickr

Navigators are federally funded counselors who are trained to help people understand their options under the Affordable Care Act.

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