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Missouri health insurance exchange

MO exchange enrollment swells to 74k, 45k qualify for Medicaid/CHIP

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Obamacare enrollment in Missouri has ended for 2014. People who get married or divorced, change jobs, have a child or experience another qualifying event may be eligible for a special enrollment period. Enrollment for Medicaid and the Children’s Health Insurance Program (CHIP) continues throughout the year. Individuals who don’t have health insurance that provides “minimum essential coverage” may have to pay a penalty: $95 or one percent of income, whichever is greater.

Open enrollment for 2015 coverage through the marketplace begins Nov. 15.

Signups for qualified health plans (QHPs) in Missouri grew 105 percent — from 74,469 as of March 1 to 152,335 — in the final weeks of 2014 open enrollment. While Missouri did not expand its Medicaid program, 45,513 people who visited the marketplace qualified for either Medicaid or the Children’s Health Insurance Program (CHIP) under existing eligibility criteria.

Among Missouri residents selecting a QHP, 85 percent qualified for financial assistance, which matches the national figure. A report released in June by the U.S. Department of Health and Human Services showed the average monthly premium, after tax credits, for Missouri consumers was $59. Fifty-seven percent of enrollees pay $50 or less per month after subsidies.

Twenty-one percent of Missouri residents selected a bronze plan (20 percent nationally), 63 percent selected a silver plan (65 percent nationally), 13 percent selected a gold plan (9 percent nationally), 0 percent selected a platinum plan (5 percent nationally) and 3 percent selected a catastrophic plan (2 percent nationally). Twenty-nine percent of Missouri enrollees were between the ages of 18 and 34.

Missouri has balked at most provisions of the Affordable Care Act. It refused to implement a state-run marketplace, rejected Medicaid expansion, and passed several laws that effectively restrict consumer assistance. Missouri requires training and licensing for navigators that go far beyond federal standards.

Legislation also prohibits navigators from providing “advice concerning the benefits, terms and features of a particular health plan, or offer advice about which exchange health plan is better or worse for a particular individual or employer.” Several health care advocacy groups challenged the restriction on providing advice, saying that is the core function of navigators. In January, a federal judge agreed and issued a temporary injunction to halt enforcement of the law.

Missouri health insurance exchange links


State Exchange Profile: Missouri
The Henry J. Kaiser Family Foundation overview of Missouri’s progress toward creating a state health insurance exchange.

Missouri Department of Insurance
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care.
(800) 726-7390 / consumeraffairs@insurance.mo.gov