obamacare

Round 2 in the legal battle over Obamacare hits the Supreme Court's intellectual boxing ring Wednesday.

In one corner is the Obama administration, backed by the nation's hospitals, insurance companies, physician associations and other groups like Catholic Charities and the American Cancer Society.

In the other corner are conservative groups, backed by politicians who fought in Congress to prevent the bill from being adopted.

healthcare.gov

More than 100,000 Missouri residents have signed up for health insurance through a federally run website during the first month of enrollment. 

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.

On a recent afternoon at his office in Hartford, Conn., Dr. Doug Gerard examines a patient complaining of joint pain. He checks her out, asks her a few questions about her symptoms and then orders a few tests before sending her on her way.

For a typical quick visit like this, Gerard could get reimbursed $100 or more from a private insurer. For the same visit, Medicare pays less — about $80. And now, with the new private plans under the Affordable Care Act, Gerard says he would get something in between, but closer to the lower Medicare rates.

On Tuesday, two federal appeals courts issued conflicting decisions that could have major ramifications for the future of the Affordable Care Act.

The controversy hinges on whether people in the 36 states that opted NOT to set up their own health insurance exchanges can qualify for subsidies (really, tax credits) on their health insurance premiums. Missouri and Illinois are among those 36 that don't have state-run exchanges.

Harum Helmy / KBIA

Consumers who want to sign up for health insurance under the Affordable Care Act have until Monday to enroll in a plan that would start on Jan. 1. But HealthCare.gov still has kinks that frustrate many consumers and navigators. KBIA’s Harum Helmy followed one Columbia resident’s journey with the website. 

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. 

 

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. 

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. 

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.

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.

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.

Marshall Griffin / St. Louis Public Radio

A Missouri Senate interim committee looking into the state's Medicaid system heard from several doctors and other health care providers Wednesday at a hearing in Jefferson City.  

Among those testifying was Thomas Hale, M.D., a St. Louis-based physician working with Sisters of Mercy.  He told the panel that Medicaid needs to be expanded to make up for the pending loss of federal reimbursements to hospitals, known as DSH payments ("dish").

Will Missouri ever play nice with Obamacare?

Jul 10, 2013
seriouslysilly / Flickr

  This week guest host Harum Helmy explains all the ways Missouri is mucking up the implementation of "Obamacare."


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.

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.

Congress votes to repeal 'Obamacare,' again

Jul 11, 2012

The Republican-led U.S. House of Representatives voted today to repeal the federal health care law. The House has voted more than 30 times to repeal or defund the Affordable Care Act. Every Republican in Congress voted for the repeal, including mid-Missouri's two representatives.