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.
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.
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.
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.”
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.
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.