Health Insurance | St. Louis Public Radio

Health Insurance

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 The health law has not been repealed.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.

An illustration of prescription drugs.
Rici Hoffarth | St. Louis Public Radio

Though Republicans in Congress have not passed a repeal of the Affordable Care Act, President Donald Trump has used a series of executive orders and directives in an attempt to peel back parts of the law.

Last week, the administration announced it would stop paying cost-sharing reductions to insurance companies for individual plans purchased through Healthcare.gov, sparking fears of insurance rate hikes just before enrollment season.  

Official estimates show that losing cost-sharing payments could push some premiums up by 20 percent in states like Missouri. In the meantime, open enrollment for individual plans opens Nov. 1.  

WBEZ

Abortions will be covered by state health insurance and Medicaid under a bill that Illinois Gov. Bruce Rauner signed Thursday.

“No woman should be forced to make a different decision than another woman would make purely based on income,” the Republican said during a news conference, after which he signed the measure privately.

He is running for re-election in 2018, and the move could prompt Republicans to put up a challenger in the primary.

Rici Hoffarth | St. Louis Public Radio

If you’re one of the about 10 million people who don't have health insurance through work and buy it on your own, this is the week to see what rate hikes your insurance company is asking regulators to approve for next year. That is, unless you live in Missouri.

State legislators approved a law last year to allow Missouri’s insurance regulator to review price increases for health insurance plans. But the state decided to postpone the deadline to share those rates with the public, citing “several significant developments impacting the individual health insurance market.”  About 240,000 Missourians buy plans on Healthcare.gov.

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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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.

Members of Local 1148 meet in Marissa, Illinois. Union president Randy Phelps sits in yellow, in yellow, said that without health insurance, he would "probably make it three months."
Durrie Bouscaren | St. Louis Public Radio

After Congress extended the deadline for retired union coal workers and their families on the brink of losing their health insurance for four months, the group is again facing the loss of their coverage at the end of April.

In the meantime, a bill to use federal funds to maintain the benefits for about 22,000 former employees of now-bankrupt coal mines has not made it out of the Senate Finance Committee. Increasingly anxious retirees have written letters to their representatives, and are looking for other forms of coverage.  

Valéria Souza, 36, hugs her step-daughter in a family photo.
provided by Valéria Souza

Three in 10 Missouri adults could have difficulty purchasing their own health insurance if the Affordable Care Act the next Congress fully repeals the Affordable Care Act. That’s because one of the act’s main provisions requires insurance companies to cover individuals with pre-existing conditions — a definition that once included pregnant women, cancer patients in remission and people with such common medical issues as obesity.  

The figures come from an analysis by the Kaiser Family Foundation, which determined that about 27 percent of American adults under the age of 65 would qualify as having a pre-existing medical condition. In Missouri, the rate is slightly higher.

Retired coal workers get 4-month extension on health coverage

Dec 10, 2016
St. Louis Public Radio

Updated Dec. 10 with results of Senate vote — With an hour to spare before a government shutdown, the U.S. Senate approved a stopgap spending bill late Friday that allows coal workers in southern Illinois to keep their health coverage until April.

Coverage for about 16,000 employees of now-bankrupt coal companies was set to run out at the end of the year. Coal state Democrats held up a vote on the bill because they wanted a longer benefits extension.

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. 

Artists are getting help navigating health-insurance options

Dec 3, 2015
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.

Stuck in the coverage gap, with dreams of being a nurse

Nov 9, 2015
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. 

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