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Kansas, Missouri Won't Set Up Obamacare's State-Run Health Insurance Exchanges

http://thinkprogress.org/health/2012/11/29/1258311/missouri-medicaid-expansion-2/ Gov. Jay Nixon

The Kansas City Star

Missouri will be unable to implement a key provision of federal health care law, Gov. Jay Nixon announced Thursday.

Meantime, Kansas Gov. Sam Brownback says he won't support an application from Insurance Commissioner Sandy Praeger to establish a state-federal health insurance marketplace.

That means it will be up to the federal government to establish health insurance exchanges in Missouri and Kansas. The exchanges are designed to be online marketplaces where individuals and small businesses can compare and buy private insurance plans.

As part of the Affordable Care Act, or Obamacare, the states face a Nov. 16 deadline to notify the federal government if they want to run their own insurance exchange. They must be open for business by 2014. When states do not open their own, the federal government will step in and set up an exchange.

"I think it's a duty best handled by the state," Nixon said, later adding: "But a state-based option is not on the table at this time."

This week, voters approved a ballot measure prohibiting the governor from establishing an exchange without the involvement of the General Assembly. The Democratic governor said that because of the constraints of that measure, and reluctance of Republican legislative leaders, the only option left is to tell the federal government Missouri will be unable to proceed with a state-based exchange.

A bill creating the "Show Me Health Insurance Exchange" cleared the Missouri House last year with unanimous support. The measure died in the state Senate, however, after several senators expressed concerns. It was never brought up during the most recent legislative session, and House leadership expressed little enthusiasm for the idea following the 2012 elections.

Brownback's decision, announced Thursday, illustrates the divide over the federal health care law between the conservative Republican governor and the moderate Republican Praeger.

Praeger, who is an elected commissioner, had been working on a grant application to seek a state-federal partnership to manage the exchange in Kansas. Brownback had to sign a letter of support before the application could be filed with federal officials.

"Obamacare," Brownback said in a news release, "is an overreach by Washington and (Kansans) have rejected the state's participation. ... We will not benefit from it and implementing it could cost Kansas taxpayers millions of dollars."

Read more here: http://midwestdemocracy.com/articles/nixon-no-state-run-health-insurance-exchange-in-missouri/#storylink=cpy

Group Health Insurance in Missour
  • No eligible applicants may be turned down for coverage or charged more because of a health problem.
  • Life changes related to family problems and job loss can affect opportunities for group health.
  • Employers may require a wait period for new employees before offering coverage.
  • Providers may review the medical history of the six months prior to acceptance for coverage in order to check for pre-existing conditions.
  • Providers may impose an exclusion period for pre-existing conditions for up to 12 months.
  • If coverage is maintained without breaks of more than 63 days, creditable coverage is available.
  • Consult employer for more information.

Small Business Health Insurance in Missouri

  • Small businesses with up to 50 employees may not be denied or cancelled due to health conditions within the employee groups.
  • Limits may be imposed on the cost of premium based on the health of an employee group of 3 to 25.
  • If the group is over 25 people, there are no limits on premiums.

Self-Employed Health Insurance in Missouri

  • The self-employed may not buy group health coverage.
  • Contact the Missouri Department of Insurance for regulations regarding affiliation with a trade or professional association offering group health insurance.

Missouri Department of Insurance
P.O. Box 690
Jefferson City, MO 65102
(573) 751-2640

Individual Health Insurance in Missouri

  • Providers may deny coverage based on health problems unless HIPAA eligible.
  • For the non-HIIPAA eligible, providers may attach an elimination rider, impose an exclusion period of up to 24 months, and review medical history for a pre-existing condition and refuse the claim based on their findings.
  • Pregnancy is classified as a pre-existing condition.
  • Providers are not required to offer credit for continuous coverage.
  • There are no limits on the cost of premiums.
  • Coverage cannot be cancelled due to illness.
  • Conversion policies are available if group coverage was held for over three months, coverage was lost, and there is no access to new group insurance.

Missouri Health Care Programs

  • The Missouri Health Insurance Program is the high risk pool for those who can not afford health insurance and have a costly health problem.
  • Medicaid, MC+ for Kids, Show Me Healthy Women, and others through the Department of Social Services are statewide programs for low income residents.

Location Status of State Exchange Decision Medicaid Expansion Decision Executive Activity
Missouri Default to Federal Exchange Supports