Health Insurance

Mike Cluck stands with his wife Nancy in the front hallway of their home in Edwardsville.  (Nov. 10, 2016)
Durrie Bouscaren | St. Louis Public Radio

An estimated 20 million people have health insurance through the Affordable Care Act, but dissatisfaction with the law helped propel Donald Trump the presidency. 

One criticism is a lack of choice for insurance plans bought on Healthcare.gov, an online marketplace established for uninsured individuals to shop for coverage. In three Illinois counties east of St. Louis, residents have just one insurance provider to choose from on the exchange for 2017, and enrollees say the coverage appears to have some serious gaps.

Charles and Doris Lehman, of Sparta, Illinois,  at the Pour House bar in Marissa, Illinois. (Nov. 1, 2916)
Durrie Bouscaren | St. Louis Public Radio

Thousands of former coal workers and dependents who worked for now-bankrupt coal companies could lose their health insurance at the end of the year if Congress does not pass legislation to fund it.

Retirees in southern Illinois say losing their health insurance would amount to a broken promise from the coal companies that would have devastating effects to their well-being. Without Congressional action, Republican president-elect Donald Trump’s promise to repeal of the Affordable Care Act makes the retirees’ coverage alternatives uncertain.

Sidney Watson, a SLU law professor and local expert on the Affordable Care Act, answered questions about health insurance premium increases in Missouri on Friday.
Kelly Moffitt | St. Louis Public Radio

By now, you’ve likely heard the headlines, news bites and chatter around the dinner table: the prices for many individual Affordable Care Act health plans are going way up across the country. Here’s a good summary of what is happening nationwide.

Angela Merten is an in-person assister for the federal online marketplace at Touchette Regional Hospital. But she says most of the people she'll help sign up for health insurance will qualify for Medicaid under Illinois' expanded program.
File photo |St. Louis Public Radio

The eastern St. Louis metro area has been particularly hard hit by health insurance companies exiting the Affordable Care Act exchange. This week, the federal government released prices for 2017, which include substantial increases in western Illinois.

Insurance brokers in Belleville say three Metro East counties — St. Clair, Madison and Monroe — will have just one insurer to choose from this year: Blue Cross Blue Shield.

Students make signs on campus at Washington University before the start of the presidential debate on Sunday.
Carolina Hidalgo | St. Louis Public Radio

It took just a few minutes for the Affordable Care Act to feature in Sunday’s presidential debate between Democratic nominee Hillary Clinton and Republican nominee Donald Trump as Trump quickly blamed the legislation for the rising cost of health care.

“When I watch what’s happening with some horrible things like Obamacare where your health insurance and health care is going up by numbers that are astronomical,” Trump said, adding that costs have gone up as much as 71 percent.

The Trump campaign has not said where he obtained his figures. But even though premiums are rising, the effect is concentrated on plans sold on the individual market not those that are provided through an employer. 

Adrian Clark | Flickr

Legislators are scheduled to meet Thursday to consider a bill that would give Missouri’s regulating agency for insurers the chance to review health insurance rates before they affect consumers who use Healthcare.gov —and allow them to object if prices are about to jump too high.  

Kelly Moffitt | St. Louis Public Radio

According to Saint Louis University Health Law Policy Center Professor Sidney Watson, there are two big dates you need to take note of for Affordable Care Act coverage:

  1. Dec. 15, 2015: The deadline to enroll in Affordable Care Act health insurance coverage in order for it to be active on January 1, 2016.
  2. Jan. 31, 2016: The deadline for the year to enroll in Affordable Care Act health insurance coverage in order for it to be active on March 1, 2016. Open enrollment won’t be available again until November 2016. 

Lisa Melandri, CAM Director, supports VLAA's initiative 'Every Artist Insured'
VLAA Twitter

Navigating health insurance can be a headache for almost anyone who cobbles together multiple part-time jobs or works freelance. According to Sue Greenberg, the executive director of Volunteer Lawyers and Accountants for the Arts, artists are particularly prone to these pains.

Katie Dorr, 29-year-old a second-year nursing student, pays $125 a month for the least expensive health insurance she could find. Enrollment is required for her to continue her studies.
Durrie Bouscaren | St. Louis Public Radio

In this season of open enrollment for health insurance under the Affordable Care Act, there’s a group of people who might be uninsured: nursing students.

Dean Puckett (left), a federal navigator, and Ashlei Howard, a certified application counselor, sit in their new offices at the St. Louis Effort for AIDS just two days before the start of open enrollment season.
Durrie Bouscaren | St. Louis Public Radio

As the third year of Healthcare.gov gets underway, an estimated 90,000 people in the St. Louis region are still uninsured and eligible to buy health insurance on the federal marketplace, according to the Centers for Medicaid and Medicare Services. 

Effort for AIDS counselors like Sade Singleton have spent the past few months leading up to enrollment doing outreach and health literacy presentations throughout the region. Last year, the nonprofit helped about 700 people sign up for health insurance in St. Louis. 

Adrian Clark | Flickr

Even Medicaid is out of reach for some of Missouri’s poorest children, who are uninsured at a rate 2.5 times as high as their counterparts in Illinois. Being uninsured can limit a child’s access to health care or wreak havoc on a family’s finances in the case of an emergency. 

New census numbers show that about 5 percent of Missouri children in families with incomes below 200 percent of poverty ($3,348 a month for a family of three) did not have health insurance in 2014. In Illinois, which has twice as many low-income families, only 2 percent of children in that demographic were uninsured.

Adrian Clark | Flickr

Large rate increases for health insurance may be in the works for some Missourians this year, but we won’t know the final prices for a few months.  

Adrian Clark | Flickr

The numbers are in: 253,969 people in Missouri signed up for health insurance on Healthcare.gov this year, or were automatically re-enrolled in their plan. That’s about 100,000 more than last year’s open enrollment period.

Rachel Bingham, a single mother, earns too much to qualify for Medicaid, but too little to afford health insurance for herself and her daughter.
Durrie Bouscaren | St. Louis Public Radio

While rolling silverware at the City Diner in St. Louis, waitress Rachel Bingham recalled her attempt to buy health insurance for herself and her five-year-old daughter last year. She said when she signed on to Healthcare.gov, she realized she couldn't afford it. 

"They were wanting $231 a month. That was not doable," Bingham said. She’s been paying out-of-pocket for doctor’s appointments ever since: $60 for primary care, $200 for the dentist. Luckily, her daughter’s a healthy kid, she said.

Adrian Clark | Flickr

Missouri lawmakers pre-filed more than 500 bills over the past month that they plan to take up during the next legislative session, which begins on Jan. 7. Here’s a selection of bills related to health care that St. Louis Public Radio’s Health Desk will be keeping an eye on in 2015:   

HB 282: Consumer Rate Review on Health Insurance Plans

Adrian Clark | Flickr

Despite progress in unemployment rates, the number of St. Louis residents who were uninsured in 2013 was almost the same as it was five years ago, according to an annual report by the St. Louis Regional Health Commission.   

U.S. Rep. Lacy Clay speaks with Rhonda and John Kiely at the health insurance resource fair at the St. Ann Community Center on Saturday, November 15, 2014.
Camille Phillips/St. Louis Public Radio

U.S. Rep. William Lacy Clay says he hopes more Missourians sign up for health insurance this year, now that the second year of open enrollment under the Affordable Care Act has begun.

More than 150,000 Missourians signed up for insurance last year—about half of those eligible. 

To mark the first day of open enrollment, the congressman visited a resource fair Saturday at the St. Ann Community Center in north St. Louis County. On-site navigators helped people sign up for health insurance, as vendors sold barbecue and salsa music played.

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

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.

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.

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:

(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.”  

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.

This article first appeared in the St. Louis Beacon: Thinking of buying insurance through the exchange?

While you wait for programmers to fix the glitch-ridden sign-up system, grab a crib sheet and learn the terms that can help you make good decisions about coverage. Pay close attention to words like PPO, POS, deductible, co-payment, drug formulary and many more.

(Via Flickr/Rosemary)

A deadline has been extended for some Illinois state retirees to submit certain health insurance documents because of the federal government shutdown.

Recipients of various state health insurance programs need to provide IRS documents by a late October deadline in order to prove that their dependents should still be eligible to receive state health insurance coverage. But as the federal shutdown drags on, the transcripts aren't being released by the IRS.

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

Starting on October 1, Missourians will be able to shop for health insurance through a new online marketplace. It’s one of the biggest changes in health insurance coverage under the federal Affordable Care Act.

But there’s still a lot of confusion about how the exchanges will work.

St. Louis Public Radio's Véronique LaCapra spoke with the Missouri Foundation for Health’s Ryan Barker to try to get some answers.

How will Missourians access the new health insurance options?

Flickr/Tax Credits

A new report released on Wednesday by the U.S. Department of Health and Human Services finds that average premiums in the new online health insurance marketplace opening Tuesday will be lower than expected in most states.

In Missouri, the average monthly insurance premium for a family of four making $50,000 a year will start at $72. That’s for the lowest level of coverage, after a tax credit.

But prices will vary depending on where in the state you live.

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