health insurance marketplace

Hope Kirwan / KBIA

Several months remain until the next open enrollment period for health insurance, but any insurance company looking to raise the cost of their plans next year had to submit their proposed increase by June 1.

In Missouri, seven insurance companies submitted rate increases for 11 different plans, with proposed raises ranging between 11 and 28 percent. Almost every company who submitted a rate increase cited the rising cost of healthcare as a reason for the change.


fhcmo.org

  It’s no secret that health insurance can be a confusing topic.

“There's not a ton of health insurance literacy,” said Aaron Swaney, Outreach Enrollment Specialist for the Family Health Center in Columbia. ”But that's true from people who have never had health insurance before to people who work in the healthcare field.”  

  

Missouri Foundation for Health

  Open enrollment for health coverage in 2015 is underway, and some Missourians satisfied with their current health insurance may be surprised to learn that parts of their plans, including premiums, are changed for the coming year. The Cover Missouri Coalition, a program of the Missouri Foundation for Health, is encouraging consumers to review their options during this year’s open enrollment period.

I spoke with Ryan Barker, Missouri Foundation for Health’s Vice President of Health Policy, about changes in this year’s health insurance marketplace.


   

healthcare.gov

  Last week marked the beginning of open enrollment for the federal health insurance marketplace, and on the surface it appears not much has changed. By some measures premiums before tax credits are just as affordable as last year - decreasing on average by about one percent according to a report by the Kaiser Family Foundation. But to be a savvy shopper, many consumers should give the marketplace a second look.

Rosemary / Flickr

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.

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? 

Marissanne Lewis-Thompson / KBIA

With the March 31 enrollment deadline for health insurance under the Affordable Care Act drawing near, healthcare centers across the state have been ramping up efforts to get Missourians signed-up. The group Cover Missouri organized a number of enrollment events across the state earlier this month.

Tax Credits / Flickr

Health care advocates are making an extra push to get people signed up for insurance through a federal website before a March 31 deadline.

The Cover Missouri Coalition says about 40 enrollment events are planned Saturday around the state, including some featuring live music, free food and advice from tax preparers. Dozens of additional events are planned in the coming days.

The coalition also will be running new online and radio advertisements between now and the end of the month.

Missouri Supreme Court
Americasroof / Wikimedia Commons

A federal judge on Thursday granted a preliminary injunction against Missouri's law requiring of a state license to serve as a navigator to help consumers sign up for coverage through the new health insurance marketplace.

An attorney for the St. Louis-based plaintiffs calls the ruling by U.S. District Judge Ortrie D. Smith a "huge victory." Messages seeking comment from state officials were not immediately returned.

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.”

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. 

 

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. 

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.

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.

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.

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. 


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.

Health money
Tax Credits / Flickr

Health and Human Services Secretary Kathleen Sebelius today announced another round of funding to help Americans enroll in the Affordable Care Act's new online health insurance marketplace.

About $150 million is now available for community health centers nationwide to hire and train employees who would provide in-person help for the public about their insurance options in the marketplace, which is set to open for enrollment on Oct. 1. 

jfcherry / Flickr

Many Missourians will likely need help navigating the Affordable Care Act's new health insurance marketplace that's set to go online by Oct. 1, but one analyst says there might not be enough time or federal funding to train those who can help.

Libby Burns / KBIA

This is the second in a two-part discussion about health literacy and the healthcare reform.  

Not knowing what the online health insurance marketplace looks like might be problematic for Missourians. 

As part of the Affordable Care Act, Missouri’s uninsured can choose to buy insurance from the state’s health exchange come October. The exchange is an online marketplace where anyone who isn’t already insured will be able to compare and purchase private insurance plans. Some uninsured Missourians would be eligible for help with the cost, too.  

Missouri has missed the deadline to create its own marketplace or start a state-federal partnership. So, the federal government is setting it up. The problem is, even though the marketplace is supposed to be open for enrollment in about six months, no one knows what it looks like yet.

“We’re losing time that could be useful in helping people understand and prepare [for the exchange],” said Catina O’Leary, the director of Health Literacy Missouri, a nonprofit group that’s working to make health care topics more understandable for Missourians. “It would be really great if we could manage people’s expectations and start training on what they’re going to need to know.”

But here's what we know so far: