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. Secretary of Health and Human Services Kathleen Sebelius speaks to reporters at St. Louis City Hall, while St. Louis County Executive Charlie Dooley, St. Louis Mayor Francis Slay, St. Louis City Health Director Pam Walker, and St. Louis County Health Director Delores Gunn look on (left to right).
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.
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.
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.
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.
Listen to KBIA's Harum Helmy chat with insurance industry 'whistleblower' Wendell Potter on Under the Microscope.
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.