Affordable Care Act

Andre Wilson, an inclusive health advocate and transgender man, will speak at Washington University in St. Louis on Nov. 13 and 14.
Durrie Bouscaren / St. Louis Public Radio

Andre Wilson lived as a woman for the first 43 years of his life. It was excruciating, he said.

“I lived a life of depression, suicidality. I couldn’t even explain to myself, let alone others, what the barriers were,” Wilson said. “One lives a life of never having access to the core self.”

When Wilson began hormone therapy to transition into becoming a man, everything changed.

Adrian Clark | Flickr

On Monday, Missourians had their first glimpse at the health insurance rates they can choose from on the federal exchange. According to some, that shouldn't have been the first time the information was public.

Missouri is one of only a few states that does not have a state entity tasked with reviewing health insurance rates before they are finalized. Consumer groups say that means Missourians might be paying more for health insurance on the federal exchange than they should be. 

Adrian Clark | Flickr

Even though open enrollment doesn't start for several days, Healthcare.gov began on Monday to allow visitors to take a peek at the individual health insurance plans and rates that will be available for 2015. 

In the St. Louis area, two additional insurance companies  — Cigna and UnitedHealthcare — began offering plans on the federal exchange. For zip codes in St. Louis, the marketplace lists 41 plans with varying monthly premiums, co-pays and deductibles.

Ryan Barker of Cover Missouri said the additional competition likely led to a slight decrease in plan prices.

Dara Taylor of Community Catalyst.
Durrie Bouscaren / St. Louis Public Radio

At a YMCA in North St. Louis, Nancy Kelley of the Missouri Foundation for Health coached about 50 navigators on how to encourage people to purchase health insurance this year.

“In some ways, we got the easy people last year. Maybe they were motivated, maybe they had some knowledge about the marketplace. So we need to get creative,” Kelley told the crowd.

152,335 people bought health insurance on the federal exchange last year, according to the Cover Missouri Coalition. The organization’s goal is to bring the amount of uninsured Missourians below 5 percent in five years.

Rep. Paul Wieland, R-Imperial
Provided

The lawyer for state Rep. Paul Wieland, R-Imperial, predicts that his suit against mandated contraceptive coverage will help launch an avalanche of court challenges to the Affordable Care Act’s provision requiring insurance companies to offer such benefits.

But first Wieland needs to persuade a federal appeals court to reinstate his case. A lower court had tossed it out.

Barnes Jewish Hospital in St. Louis
courtesy of Barnes Jewish Hospital

A health industry report published Thursday suggests federal programs that tie hospital quality scores to Medicare reimbursements are giving St. Louis hospitals a reason to improve.

Seventeen St. Louis area hospitals received bonus payments this year from Medicare thanks to programs in the Affordable Care Act that reward hospitals for providing a high quality of care. At the same  time, 25 were penalized for low scores, high readmission rates or failing to improve between 2011 and 2012.

(via Flickr/Jennifer Boriss)

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.

(Credit: Nora Ibrahim, St. Louis Public Radio Intern)

Paramedic Jaclyn Kloecker has experienced her share of tension, turmoil, rising adrenaline and blaring sirens. She's been responding to 911 calls and rushing the sick or injured to emergency rooms for 15 years. 

On a recent rainy morning, however, Kloecker wasn't responding to an emergency. Rather, she was on a calmer, quieter mission, performing medical screenings aimed at reducing the number of 911 calls that Christian Hospital’s Emergency Medical Service system handles.

In his hospital room at Touchette Regional Hospital in Centerville, patient Steven Glispie finishes signing the paperwork to enroll in Medicaid.
Véronique LaCapra | St. Louis Public Radio

For years in most states, Medicaid eligibility had been limited to disabled adults, seniors needing long-term care and very low-income parents with their children.

Then along came the Affordable Care Act. It was designed to grow health insurance coverage across the board. One of its tenets was to expand Medicaid coverage beyond the extremely poor and disabled to include all adults earning up to 138 percent of federal poverty levels.

But in 2012, the Supreme Court gave states the chance to opt out Medicaid expansion.

Flickr Creative Commons Users/Compiled By Kelsey Proud, St. Louis Public Radio

The Obama administration says it will give people more time to sign up for health insurance through the federal online marketplace.

(UPI/Bill Greenblatt)

Last week, people all over St. Louis – and all over the Midwest and East Coast, probably – celebrated the official start of spring. They celebrated because the winter has been unusually long and cold and, somehow, darker than usual. And they celebrated with a tinge of worry that the brutal winter could give way to an equally brutal, hot summer.

If that does happen, be prepared for a lot of talk about climate change. 

Nanette Hegamin

The first open enrollment period for insurance under the Affordable Care Act ends March 31, and individuals who don’t have insurance by that deadline could face penalties.

Joining us to discuss enrollment, the deadline, and those penalties were three guests who are experts on what the Affordable Care Act provisions mean for Missourians:

Jason Rosenbaum, St. Louis Public Radio and the Beacon

U.S. Health and Human Services Secretary Kathleen Sebelius tried to put a price tag and a face on the government’s health reform push in Missouri when she visited the Grace Hill Water Tower Health Center on Friday. 

The price tag: $5 million a day. That’s how much she says Missouri is losing by refusing to expand its Medicaid program under the Affordable Care Act.

The face: a local resident who praised the law for the help it is providing his family while he attends law school.

(via Flickr/Jennifer Boriss)

As of January 1st, the first Americans enrolled in health insurance via the Affordable Care Act began receiving coverage.

According to Professor Sidney Watson of the Saint Louis University Health Law Policy Center, a little more than 33,000 Missourians have signed up for plans through the federal Marketplace so far, leaving another 467,000 Missourians eligible to enroll. Almost 26,000 Missourians have enrolled in Medicaid.

“We think most of them are children,” Watson said. “Parents were going to the Marketplace and realizing their children were eligible.”  

Ryan White, the Indiana teenager who, after contracting AIDS at age 13, advocated for a more considered approach to those facing AIDS-related illnesses.
(via Wikimedia Commons/Wildhartlivie)

The centerpiece of the federal government’s war against HIV/AIDS bears the name Ryan White.  

The public might not remember him without a little context. A hemophiliac who was diagnosed with AIDS at age 13, White drew international attention when he not only had to cope with the disease but also had to wage a legal fight to attend school with his classmates in Kokomo, Ind.,  following his diagnosis. He died in 1984 at the age of 18 after becoming a poster child for more compassion, counseling and medical care for those facing AIDS-related illnesses.

Flickr Creative Commons Users/Compiled By Kelsey Proud, St. Louis Public Radio

UPDATE: 12-27-13

Even if you missed the Christmas Eve deadline to sign up for health insurance under the Affordable Care Act, you may still be able to have your coverage kick in on Jan. 1.

Hollee Brooks
Robert Joiner/St. Louis Public Radio and The Beacon

Following years of dead-end jobs in the fast-food industry, Hollee Brooks decided to trade her restaurant uniform for scrubs, and train to become a medical technician. If she makes it through nine months of training and gets state certification and some experience, she'll earn considerably higher wages and enjoy employment benefits that usually elude those who flip hamburgers for a living. 

This commentary first appeared in the St. Louis Beacon: When I was a kid, Halloween was the day we gave thanks for attending Catholic school. Because the day after is All Saint’s Day in church liturgy, we were off for a holy day of obligation while our public-school counterparts attended classes as usual after a night of trick or treating. (Suckers.)

Commentary: Hard lessons from the ACA roll-out

Nov 25, 2013

This article originally appeared in the St. Louis Beacon. - As a professor of public policy I am always on the lookout for events that I can use as Teachable Moments in the classroom. The rollout of the Affordable Care Act, aka Obamacare, certainly qualifies as a case study of what not to do when implementing a new public policy.

(Via Flickr/Rosemary)

Missouri will allow health insurance companies to continue offering policies that otherwise would have been canceled under the terms of the new federal health care law.

Gov. Jay Nixon announced Thursday that the state will let insurers sell individual and small-group policies in 2014 that were to be canceled because they didn't meet federal coverage requirements taking effect next year. 

This article originally appeared the St. Louis Beacon. - The rocky rollout of the Affordable Care Act's insurance marketplace apparently hasn’t changed the level of consumer support for the health-reform program. For weeks, administration officials and policy analysts have been concerned that many people were confused about the law and might be turned off because of difficulties buying insurance through the insurance exchange.

This article first appeared in the St. Louis Beacon. - Missouri Republicans in Washington and Jefferson City are standing firm in their opposition to the Affordable Care Act. They are citing the low number of Missourians who have signed up for insurance on the federal exchange as just another reason why their stance hasn’t changed -- and won't.

via White House video stream

This event has concluded, thank you for joining us.

President Obama is addressed the nation this morning regarding the Affordable Care Act. Thanks for joining us live on-air at 90.7 FM and streaming online.

This article first appeared in the St. Louis Beacon. - The latest wrinkle in the Affordable Care Act centers on whether consumers should be allowed to keep health insurance plans that may offer less coverage than the minimum benefits envisioned in the health-care law.

This article first appeared in the St. Louis Beacon. - Individual insurance policy holders in Missouri may be allowed to keep their policies in 2014, even if they don’t comply with the Affordable Care Act.

Missouri Gov. Jay Nixon has announced that his administration’s Department of Insurance is notifying health insurers that they will be allowed to extend such policies, if they desire.

(WikepediaCommons)

Missouri Senator Claire McCaskill said today that President Obama should’ve apologized to the millions of Americans whose health insurance was canceled because it failed to meet Affordable Care Act requirements.

“These problems are inexcusable, and it’s embarrassing,” McCaskill said. 

McCaskill’s comments follow remarks made yesterday by former President Bill Clinton, who said President Obama should find a way to let people keep their health coverage, even if it means changing the new insurance law. 

This article first appeared in the St. Louis Beacon. - After months of lying low on the topic of Medicaid expansion, Missouri Gov. Jay Nixon appears to be resurrecting the issue with Tuesday's invitation to General Assembly leaders to join him “for a discussion about reforming our state’s health-care system to provide better outcomes for patients and better returns for taxpayers.”

(Via Flickr/Rosemary)

The St. Louis-based safety-net healthcare provider ConnectCare will close its remaining facilities at the end of next week.

The Smiley Urgent Care Center, along with ConnectCare’s radiology, pharmacy, laboratory and preventative services will all close on Nov. 15.

The nonprofit organization, which served patients regardless of their ability to pay, had already discontinued outpatient specialty care and transportation services last month.

U.S. Sen. Roy Blunt, R-Mo.
Senator Blunt | Flickr

Missouri Senator Roy Blunt says the federal government's difficulty launching Healthcare.gov this fall is not really what's wrong with the Affordable Care Act.

President Obama's administration has struggled to address a myriad of problems with the site since launching Oct. 1, including users being unable to create accounts and load web pages.

Blunt cautions residents not to consider the website as a measure of whether or not the President's signature health care plan is working.

This article first appeared in the St. Louis Beacon: Joyce Simms has been a St. Louis ConnectCare patient in the pulmonology program for four years.  Because she has asthma, she sees her pulmonologist, Dr. Barbara Lutey, as often as every three months.

In August, Simms received a registered letter from ConnectCare telling her that the pulmonology clinic was closing. But Simms did not experience even a hiccup in service. She learned that she would be able to continue to see Lutey, but her appointments would be at the Center for Outpatient Health, a facility run by Barnes-Jewish Hospital on Forest Park Avenue.

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