Affordable Care Act | St. Louis Public Radio

Affordable Care Act

Missouri Secretary of State Jason Kander greets supporters as they welcome him to the stage at The Pageant on Oct. 28, 2016.
Carolina Hidalgo | St. Louis Public Radio

St. Louis Public Radio’s Jason Rosenbaum and Jo Mannies look at three things playing a big role in Missouri’s 2018 election cycle.

The first is debate over pre-existing conditions between U.S. Sen. Claire McCaskill and her GOP opponent Josh Hawley. It stems from Hawley’s decision to be a part of a lawsuit seeking to upend the Affordable Care Act.

The study examined over 580,000 patient records collected over a 20-year period and found women were more likely to survive a heart attack when treated by a female doctor than a male doctor.
Maria Fabrizio | NPR

A new survey from the U.S. Census Bureau found the Missouri uninsured rate remained steady at 9.1 percent in 2017 despite several Congressional attempts to gut the Affordable Care Act and the repeal of the individual mandate, the requirement that all Americans have insurance.

Missouri’s percentage of uninsured people is in line with the national rate of 9 percent. The number of uninsured people nationwide has been falling since 2013, when it was 13.4 percent.

Missourians buying health insurance on the federal exchange likely won't see the sky-high rate increases that have becoming common in recent years in 2019. But experts say the marketplace's woes are far from over.
David Kovaluk | St. Louis Public Radio

When Missourians go to healthcare.gov to buy health insurance, they likely won't be shocked by double-digit increases this year, according to data filed Wednesday with the state’s insurance department.

Three existing carriers — and one new entry into the market — will offer plans with smaller increases than previous years. Two insurers offering healthcare.gov plans are asking for modest rate increases.

Healthy Alliance Life Insurance plans an average increase of about 4 percent, and Cigna’s plans will increase about 7 percent. Centene's Celtic Insurance plans an average decrease of 9 percent.

The rate filings will not be finalized until late fall.

Insurance premiums for plans on healthcare.gov have become more expensive, but most people who buy exchange plans on healthcare.gov receive tax credits to help them offset costs. Those who don’t receive those credits bear the brunt of those higher prices.
David Kovaluk | St. Louis Public Radio

The rising costs of insurance plans available through the federal healthcare.gov website may make them unaffordable for some people in Missouri and Illinois.

Premiums for exchange plans on healthcare.gov have become more expensive, but most people who buy exchange plans on healthcare.gov receive tax credits to help them offset the cost and are insulated from rising costs. But those who don’t receive those credits bear the brunt of those increased prices.

Missouri and Kansas have joined 18 other states in seeking to have the Affordable Care Act declared unconstitutional following Congress’ repeal last year of the tax penalty associated with the individual mandate.

In a lawsuit filed late Monday in federal court in Texas, the coalition of 20 mostly red states claimed that the elimination of the tax penalty for those who don’t buy health insurance renders the entire healthcare law unconstitutional.

Medical assistant Raquis Tyler, Dr. Heidi Miller and nurse Cindi Boehm discuss treatment plans for patients at Family Care Health Centers in St. Louis.
File photo | Tim Lloyd | St. Louis Public Radio

Once again, people who don’t get health insurance through their job are logging into online market places set up by the Affordable Care Act to buy it on their own. This year, the enrollment season is shorter —  six weeks — but business is brisk.  

In the first four weeks of this year’s enrollment season, 78,676 Missourians enrolled in a plan, according to numbers released Wednesday by the Centers for Medicare and Medicaid Services. That’s about 17,000 more people than were signed up during the same period last year.  

In Illinois, the four-week total was 95,434, up from 68,198 in 2016.

5 Points To Keep In Mind When Shopping For Health Insurance This Year

Oct 31, 2017

Open enrollment for people who buy their own health insurance starts Wednesday and ends Dec. 15. That means there are only 45 days to shop for coverage. The shorter enrollment period this year is just one of the changes to the process for buying insurance under the Affordable Care Act.

Here are five important factors to keep in mind if you plan to sign up for ACA coverage for 2018.

1. The health law has not been repealed.

Despite the efforts of President Trump and the Republican-led Congress, the Affordable Care Act remains the law of the land.

Sidney Watson, the Jane and Bruce Robert Professor at Saint Louis University’s Health Law Policy Center
Alex Heuer | St. Louis Public Radio

On Friday’s St. Louis on the Air, Don Marsh talked with Saint Louis University health law professor Sidney Watson about the just released 2018 premiums for policies through the Affordable Care Act and discuss how Missourians and St. Louisans will fare.

This Behind the Headlines discussion was a follow-up to a conversation about what's happening with healthcare in the United States.

Sidney Watson, the Jane and Bruce Robert Professor at Saint Louis University’s Health Law Policy Center
Alex Heuer | St. Louis Public Radio

It’s difficult to keep track of day-to-day news about what’s happening with the Affordable Care Act.

What do President Donald Trump’s executive actions do? What’s the latest information about efforts in Congress to deal with the ACA?

On Thursday’s St. Louis on the Air, host Don Marsh talked about the Affordable Care Act with Sidney Watson, the Jane and Bruce Robert Professor at Saint Louis University’s Health Law Policy Center.

“It’s certainly a time of chaos and daily confusion,” Watson said.

On Thursday, U.S. Sens. Tammy Duckworth, D-Ill., Roy Blunt, R-Mo., Claire McCaskill, D-Mo., and Dick Durbin, D-Ill., cast late night votes for and against the most recent health care bill making rounds on Capitol Hill.
Ryan Delaney, Gage Skidmore, Center for American Progress

After another Republican Senate loss early Friday, Missouri and Illinois senators are calling for a return to bipartisan talks to overhaul the nation’s health care law.

They include U.S. Sen. Roy Blunt, a Missouri Republican, who had tried to help his party’s leaders come up with the votes needed for a trimmed-back version of a bill that would have repealed key provisions of the Affordable Care Act, the signature achievement of former President Barack Obama.

Lacy Seward, social services coordinator for the Monroe City Manor. Medicaid cuts proposed by Senate Republicans could hit hard in this small town, that helped vote them into office.
Durrie Bouscaren | St. Louis Public Radio.

MONROE CITY, MO. — The closest emergency room is 20 miles east on the highway. That’s why it isn’t unusual for people experiencing heart attacks, blood clots and strokes to show up at Dr. Rodney Yager’s clinic on Main Street in Monroe City.

Yager, who grew up in the area, can handle the fast pace of a small-town clinic. What worries him more is how federal health care policies being shaped in Washington, D.C., could affect his patients.

For sickle cell patients, opiods are often the only pain relief. But growing rates of addiction among the general public mean emergency room doctors are more cautious than ever in prescribing those powerful medications, causing challenges for sickle cell
Carolina Hidalgo | St. Louis Public Radio

Anthem Blue Cross Blue Shield, one of Missouri’s largest insurers, no longer covers emergency room visits that it deems unnecessary.

The policy aims to save costs and direct low-risk patients to primary care physicians and urgent care clinics. But doctors say patients may avoid going to a hospital when they really need it, if they fear a large bill.

Centene Corp. will step into the breach created by Blue Cross and Blue Shield of Kansas City’s decision last month to exit the Affordable Care Act marketplace in 2018.

The Clayton, Mo.-based insurer will begin selling health plans next year in all 25 western Missouri counties that Blue KC’s withdrawal would have left “bare” — that is, without any insurer offering health plans in the individual market. 

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CHART: CBO weighs who wins, who loses with Senate health care bill

Jun 27, 2017
Supporters of the Affordable Care Act rallied in front of the White House in late February 2017
Ted Eytan | Flickr

The nonpartisan Congressional Budget Office weighed in on the Senate health care bill on Monday, saying that 22 million people would lose health coverage in the next 10 years under the Senate's plan. Of those, 15 million would lose Medicaid coverage. It's projected to lower the deficit by billions over 10 years, and also cut taxes on corporations and the wealthy.

Rici Hoffarth | St. Louis Public Radio

Updated June 27 with a new timeline:

Republicans in the U.S. Senate said Tuesday they would delay a vote to pass their plan to replace the Affordable Care Act.

The Senate's Better Care Reconciliation Act would reduce the federal deficit by $321 billion and leave 22 million more people uninsured by 2026, according to Monday’s estimate by the Congressional Budget Office. Like the House plan, it slashes Medicaid and allows states to redefine what’s covered in a basic health insurance plan, in a bid to lower costs.

Susannah Lohr | St. Louis Public Radio

Next year, Blue Cross Blue Shield of Kansas City will leave the individual health care marketplace in Missouri that was set up under the Affordable Care Act. And when it does, about 18,000 patients in 25 western Missouri counties will lose their health insurance. If those enrollees sign on to Healthcare.gov this fall to buy a replacement plan, they may have no options to choose from.

That's because those 25 counties could become "bare."

Three weeks after Blue Cross and Blue Shield of Kansas City said it will pull out of the Affordable Care Act exchange in 2018, Centene Corp. says it plans to offer coverage through the exchange in Missouri and Kansas.

The St. Louis-based insurer already has a presence in both states administering Medicaid plans, but the move to sell individual and small group health plans is new.

For the hundreds of rural hospitals struggling to stay in business, health policy decisions made in Washington D.C. this summer could make survival a lot tougher.

David Mueller, 31, picks up his three-year-old daughter Marjorie from daycare on May 4, 2017. She has a rare form of cystic fibrosis, and Mueller worries the Republican health plan will affect the family's ability to pay for her care.
Durrie Bouscaren | St. Louis Public Radio.

A Republican proposal to gut the Affordable Care Act narrowly passed the U.S. House of Representatives and now the U.S. Senate is crafting its own bill to reshape the nation’s health care system. Elected officials have held few town halls to hear from constituents in the St. Louis area about what they want in a health care bill, sparking demonstrations outside representatives’ offices.

Barb Fleming of Bel-Nor enrolled in Missouri's high-risk pool after a breast cancer diagnosis in 2008. Today, she pays much less for a plan through the Affordable Care Act.
Durrie Bouscaren | St. Louis Public Radio.

Barb Fleming had built a small business selling tableware and wedding gifts. But that career nearly came crashing down around her in 2008, when her doctor found a lump in her breast. 

Months later, Fleming, of Bel-Nor, in St. Louis County, would find herself in Missouri's high-risk pool: a pricey, state-managed insurance plan that covered people with pre-existing conditions. The programs were phased out by the Affordable Care Act, but could return in the sweeping health care proposal passed this month by House Republicans.

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