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First committee hearing on healthcare markets leaves stakeholders asking for direction


JEFFERSON CITY, Mo. – The first meeting of the Interim Committee on Stabilizing Missouri’s Health Insurance Markets, tasked with looking at Missouri’s healthcare options, seemed to end with one clear sentiment from those on the committee: they need an outline of the parameters they will be working in.

The Wednesday morning meeting proved to be as muddy as the waters of the healthcare situation in the Show-Me State and the federal level; too many questions and not enough answers.

The hope is to identify the current situation of Missouri’s health insurance market and what led to those results, but Chairman Justin Hill hopes to also develop solutions for a long-term plan. Right now in Missouri, most counties in the Show-Me State are currently only covered by one provider, following the departure of two insurance companies – Humana and Blue KC –  with a few options left with companies like Centene and Cigna. In fact, there is no single county in Missouri where citizens will have more than two carrier options.

“We’re in dire straits here for Missourians and making sure that they have quality and affordable health insurance,” Hill told the committee.

The committee’s mission is to look at “how the rollback of the Affordable Care Act will alter the health insurance climate in Missouri” as well as determining whether Missouri should pursue a federal waiver to sidestep the requirements of the ACA.

A Section 1332 waiver authorizes states to waive key requirements in order to experiment with different health coverage models in an attempt to reform their healthcare markets.

To see a checklist of how to complete the required elements of the application, click here.

“It’s my hope that Missouri will apply for the waiver by the end of next session,” Hill said.

Under the ACA, enacted in 2010 by former President Barack Obama, individuals are required to have health insurance through either an employer, private insurer or the public market. Republicans have long wanted to roll back the ACA, and without a repeal-and-replace bill being sent to the White House, President Donald Trump’s administration plans to stop delivering subsidy payments to the insurers. In essence, it would mean higher premiums in an already thin market in Missouri.

Missouri has long resisted the ACA, choosing not to exercise its option for expanded Medicaid coverage under Obamacare. If they had, then the federal government would have paid nearly all of the cost for extra coverage, backing it off to 90 percent cost-share in the year 2020.

All of this has led to a number of questions, which the interim committee hopes to find some answers to. But Wednesday’s meeting did little to aid in that regard, as the Chairman found himself receiving silence from the room when asking questions about the status of the markets and the future outlook.

“Mr. Chair, perhaps if you’d make some assignments we’ll have some testimony for the next meeting,” one audience member responded.

Hill identified a number of areas to look into, including the current status of the market, what insurers see moving forward, the status of uncompensated care and bad debt with hospitals, and other trends that are occurring.

It was agreed that the parameters should be set forth to stakeholders, in order to direct them on what resources, data, and answers the committee needed.

Hill said that he hopes for the committee to meet at least three times before the end of the year, and expects the next meeting to take place following Thanksgiving.