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.
But some still won't be able to afford it. She said that's where Medicaid expansion would have made a difference "because a number of those 800,000 qualify for Medicaid, and are very low income, working Missourians, who won't have affordable options if the Medicaid expansion isn't taken up."
An analysis by the national healthcare consumer advocacy group Families USA found that about 525,000 Missourians ― those with incomes between 100 and 400 percent of federal poverty levels ― will be eligible for financial assistance to help them purchase health insurance through the new marketplace.
But Sebelius said those whose income is less than 100 percent of federal poverty levels will have to pay full price.
That’s because they would have been covered by Medicaid, had Missouri opted to expand its program.
Sebelius said the state will also miss out on billions of dollars in federal support.
"In the first six years, there's more than $8 billion of federal funding that Missouri could receive for newly enrolled, Medicaid eligible citizens, that will not come to the state," Sebelius said.
Even though the federal government would have covered the cost of Medicaid expansion for the first three years, and about 90 percent of the costs after that, opponents in the state legislature say it would be too costly.
Follow Véronique LaCapra on Twitter: @KWMUScience