JEFFERSON CITY Mo. — The Missouri Foundation for Health implemented a new strategic plan last March called the Expanding Coverage Initiative. The goal was fairly simple, if daunting: to bring the number of uninsured Missourians down to less than 5 percent of the population in the next five years.
To meet this goal, the Foundation created Cover Missouri, a coalition of individuals and organizations aimed at expanding access to health insurance across the state. And while the Missouri legislature is busy debating the politically dicey decision of expanding Medicaid access as called for by the Affordable Care Act, Cover Missouri actually has a different immediate goal.
“Our goal for 2013 is to focus on awareness and enrollment in healthcare exchanges,” Ryan Barker, Vice President of Health Policy for MFH, told The Missouri Times. “Open enrollment in (Missouri’s) healthcare exchange begins October 1, and the vast number of the uninsured aren’t even aware of what it is or does.”
Missouri citizens voted against setting up a state-funded and run healthcare exchange by popular vote in 2012. The exchanges were essentially designed to let people without access to group insurance to purchase group insurance priced healthcare online. The ACA called for states to set up these exchanges themselves, or have the federal government step in and establish them.
A ballot measure prevented Nixon from establishing the exchanges, and the Republican-led Missouri legislature did not act on any implementation during session, leading to the federal exchange. While Barker said the exchange would allow the uninsured to enter a marketplace and purchase insurance with options for subsidization based on income, many of the uninsured are not even aware the option exists.
As Cover Missouri looks to increase awareness with meetings around the state and community engagement, they are also deploying individuals to help the uninsured manage the actual enrollment process and find the right insurance plan.
“We’ll fund counselors throughout the state,” Barker said. “We’re looking at a pretty good geographic spread. We’ll help people find what works for their family, what they can afford, and what they need to do to get enrolled and start receiving insurance.”
With more than $8 million allocated by MFH to fund awareness and enrollment activities, he said approximately half of the goal of reducing the uninsured in Missouri to under 5 percent can be reached by optimizing the healthcare exchanges.
Of individuals under 65, 17 percent in the state of Missouri have no health insurance, or about 876,000 individuals. Cover Missouri will need to find health insurance for about 600,000 Missourians to meet their goal. Medicaid expansion, if realized as Democrats have pushed for, would cover anywhere between 200,000 and 300,000 Missourians, as estimate vary. So healthcare exchanges are pivotal, Barker said.
Barker said MFH’s undertaking was so large in part because the state received relatively little federal money to help establish the exchanges. Currently, the federal government is providing grants to every state to fund individuals — certified application counselors also referred to as “navigators” — trained in assisting citizens in enrolling in and utilizing healthcare exchanges. In states that chose to establish their own exchange, the grants total in the tens of millions of dollars, Barker said. However, federal grants for Missouri navigators total $1.3 million.
“It’s extremely important that we help consumers in this area,” Barker said. “We’re getting no money from the state and very little from the federal government, so we’re contributing quite a lot to this effort.”