affordable care act

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.

Affordable Care Act
whitehouse.gov / whitehouse.gov

The wait is over for Missourians hoping to find out whether the Affordable Care Act lives up to its name when it comes to shopping for government-backed health insurance.

Watch the show and join the conversation on the Intersection website.

401(K) 2013

Starting Oct. 1, anyone looking to purchase health insurance plans can enroll in the new online marketplace. A key component of the Affordable Care Act, the marketplace has been touted as a totally new way to buy insurance. You, the consumer, can go to the marketplace website and do a side-by-side comparison of the benefits, premiums and coverage of different insurance plans.

U.S. Health and Human Services Secretary Kathleen Sebelius was in St. Louis on Thursday to talk about the Affordable Care Act.

Sebelius met with city and county officials and representatives of the local healthcare community in a closed-door session at St. Louis City Hall.

Speaking at a press conference after the meeting, Sebelius said as of October 1, Missourians will be able to purchase health insurance through a new online marketplace.

Sebelius said many of Missouri's 800,000 uninsured will be able to get coverage.

Grant Gerlock / Harvest Public Media

On this week's episode, we'll hear why some rural residents are reluctant to sign up for insurance under the Affordable Care Act.

Alan Cleaver / flickr

In about one month, a key part of the Affordable Care Act kicks off nationwide. The health insurance marketplace opens for enrollment -- and consumers can shop for an insurance plan from what could be hundreds of options. And this week, a Missouri-wide campaign to raise awareness about the marketplace begins, it's led by the Missouri Foundation for Health. States had the option to run their own marketplaces or let the federal government do it for them. Missouri, along with 26 other states, chose the latter. 

Alan Cleaver / flickr

Primaris Healthcare Business Solutions and the Missouri Alliance of Area Agencies on Aging have been granted federal money to hire people who will help Missouri consumers navigate the new insurance marketplace, set to open for enrollment on Oct. 1.

The Department of Health and Human Services’ Centers for Medicaid and Medicare Services quietly announced the grantees Thursday.

Teddy Nykiel / KBIA News

 

Echoing testimonies from earlier hearings in Independence and Springfield, witness after witness spoke in support of Medicaid expansion at a House interim committee hearing in Columbia on Saturday.

Alan Cleaver / flickr

The Department of Insurance has issued an emergency rule for licensing people who will help Missouri residents explore their insurance options in the new health marketplace. The federal government is regulating these helpers, also called navigators. A bill signed by Gov. Jay Nixon earlier this month added state regulations for the navigators.

jfcherry / Flickr

The Missouri Department of Insurance has filed an emergency rule for the licensing of people that will help state residents search for health plans on an online marketplace. Legislation signed this year by Gov. Jay Nixon creates state requirements for the helpers, who are called navigators.

People applying for a state license will need to pass an examination. The cost for applying will be $25 for individuals and $50 for an entity. Licenses will be valid for two years. Requirements for a navigator license will include being age 18 or older, living in Missouri or keeping a business in the state. Those wanting to be navigators also should not have committed any acts that would grounds to refuse an insurance producer license.

Alan Cleaver / flickr

For about two decades, Wendell Potter spun carefully crafted public relations messages for Humana and Cigna, the insurance companies where he worked. He recalls convincing consumers that high-deductible insurance plans would be good for everyone; telling them that by paying more, they’d have more skin in the game of their own health.

“I frankly just got so disillusioned and, ultimately, disgusted with what I was doing,” Potter said.

He said through his own research, he knew high-deductible plans were not the best insurance coverage for those with middle-class income.

“The median household income in this country is just barely $50,000,” Potter said. “A family that’s earning $50,000, if they’re in a plan with a high deductible, they face bankruptcy or foreclosure [if something happens]. I’ve talked to a lot of people who have lost their homes and have to declare bankruptcy because they have been in these kinds of plans. They think they have adequate coverage and they don’t.”

In 2008, Potter left the insurance industry and became a consumer advocate. He testified in Congress against high-deductible plans. In 2010, he published a book detailing the ways public-relations practices of the insurance industry affect American health care. 

Now, Potter writes columns and travels around the country to debunk what he calls are “myths” about the Affordable Care Act. The law imposes stricter rules on insurance companies. They can no longer refuse coverage for consumers who have a pre-existing condition, for example. Companies also have to spend at least 80 percent of every dollar of a consumer's premium for patient care and quality improvements, not profits or administrative costs. 

On a recent visit to Columbia, Potter sat down with KBIA's Harum Helmy to chat about health care reform and the insurance industry's response to it. 


roy blunt
TalkMediaNews / Flickr

Missouri’s Roy Blunt was among the Republican Senators signing a letter Wednesday asking President Barack Obama to permanently delay the implementation of the Affordable Care Act.

pinprick / FLICKR

 Update: Gov. Jay Nixon signed SB 262 into law on Friday, July 12. 

A bill that was pushed by the state's insurance agents association could create a barrier in getting Missourians enrolled in time for the new online health insurance marketplace  one of the key parts of the health care reform law.

File photo / KBIA

Missouri is facing a shortage of primary care doctors, and the strain could grow as more people soon gain health insurance under the federal health care law.

The state had just under 74 active patient care primary care doctors per 100,000 residents, according to 2010 figures from the Association of American Medical Colleges. That ranked Missouri 35th in the nation and put it behind the national per capita average of more than 79 active primary care doctors per 100,000 residents.

Teddy Nykiel / KBIA

A former health insurance company executive says he left the comforts of a padded career of corporate jets and high rise offices to speak out against unfair insurance practices.

KBIA file photo

Thirty-five MU Health Care employees will see their hours reduced in the coming year. At Boone Hospital Center, seven employees’ hours will be cut, while 13 full- and part-time employees will lose their jobs.

In Boone Hospital’s case, the layoffs came in a system-wide package. The hospital’s parent company, St. Louis-based BJC Healthcare, recently announced it is cutting 160 jobs from its hospitals. This is the first time BJC has ever made system-wide layoffs. June Fowler, vice president for corporate and public communications at the company, said several factors led to the layoffs.

“BJC is experiencing reductions in our reimbursement for the healthcare services that we provide,” Fowler said.  “We’ve also seen a decrease in inpatient hospitalizations.”

Teddy Nykiel / KBIA News

 

Although the Missouri legislative session has ended, the discussion on what to do with the state’s Medicaid program continues.

The Affordable Care Act asks states to expand their Medicaid eligibility to cover those who earn up to 138 percent of the federal poverty level. That’s about $30,000 for a family of four. Missouri’s Republican-majority legislature has refused to expand Medicaid, calling it a broken system. Now, both the state House and Senate have established interim committees to study ways to reform Medicaid.

Teddy Nykiel / KBIA News

  Missouri state lawmakers launched an interim committee Thursday to examine the issue of Medicaid reform. Governor Jay Nixon pushed heavily for the legislature to expand Medicaid this session, and accept hundreds of millions of federal dollars to do so. But Republican legislators were worried about the long-term costs of the move, and no measure was passed. Missouri House Speaker Tim Jones, a Republican member who started the committee, says accepting the federal money wouldn’t fix the problems that are inherent to the Medicaid system.

This week on KBIA’s talk show Intersection, host Ryan Famuliner sat down with State Sen. Kurt Schaefer (R-Columbia), Rep. Caleb Rowden (R-Columbia) and Rep. Chris Kelly (D-Columbia) to discuss the legislative session that ended on Friday. One of the main things on the show’s agenda was, of course, Medicaid expansion – or lack thereof.

Famuliner asked the panelists why the expansion failed to pass. 

Health care reform put on hold as lawmakers wrap up session

May 16, 2013
Jennifer Davidson / KSMU

Rain is drizzling on the roughly 40 people standing in line outside the Good Samaritan Care Clinic in rural Mountain View, Missouri. Some have been standing for hours. At 5:30 pm, the clinic doors swing open, and the patients flood into a clean, bare bones waiting room.

Kellie Kotraba / KBIA News

  

With the Missouri legislative session ending on Friday and a Republican supermajority that still won't budge, the hope to expand Medicaid in Missouri is pretty much dead for FY 2014.

It's so dead that perhaps the only thing that could bring it back to life is, well, interfaith prayers for a miracle.

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