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.
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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.
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.
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.
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.
Listen here for an interview with Stan Hudson, a health literacy expert and associate director of the Center for Health Policy at MU about the Marketplace Navigators program.
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.
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.”