Affordable Care Act

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

On Saturday, open enrollment season for Healthcare.gov begins. For the second time around, public health organizations and insurance "navigators" are holding outreach events, running ads, and looking for the remaining uninsured Missouri residents.

But who are those uninsured Missourians? And how have the changes implemented through the Affordable Care Act affected the state?  

Hundreds of thousands of people in Missouri are uninsured. Who are they?

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 / 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 / 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. 

(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. 

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.

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