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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

Why the health insurance marketplace could be called a success in Missouri

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 Last month the U.S Department of Health and Human Services announced that more than 150,000 Missourians have signed up for health insurance under the ACA and many will be paying $60 or less a month for their plan after tax credits.

I talked with Karen Edison, founding director of the MU Center for Health Policy about why this could be called a success in Missouri.

Based on recent evaluations of the marketplace and your studies on healthcare reform, what's the situation with health insurance in Missouri?

So we have a federal health insurance marketplace in Missouri. We have no coordination by the state because they're prohibited by doing that by Proposition E. We have no expansion of Medicaid. We had some funding behind education through the Missouri Foundation for Health. So in that milieu, we had over 150,000 people who signed up for health insurance in the first wave. That is very remarkable. And I think it reflects the pent up demand for affordable health care services.

So do you think that we're going to see even more Missourians going to the marketplace for insurance in the future?

I think the whole health reform debate, unfortunately, really got politicized. If you get them away from the cameras and get them behind closed doors, everyone will admit that we have to do something different in healthcare. We are spending way too much money and we're not getting the results that we need. Quality has been uneven. We do have the best healthcare system in the world in certain areas if you are of means. If you don't have money, that health care can be spotty. We had people going to the Emergency room for their healthcare because that's the only place they had to be seen. We've had people not getting healthcare, we've had people who put off going in because they don't have insurance, and those people die younger, those people suffer more…. Because of those tax subsidies, because of those tax credits that small businesses can apply for and get, a lot of people now are finding health insurance coverage affordable where before it really wasn't affordable to them.

How are we comparing to maybe Illinois who has expanded Medicaid and surrounding states?

Arguably, we did a better job with signups than many states that put a lot more into advertising. And I really think it’s a consequence of where we started.

Is the marketplace working? Are we going to continue to see a positive movement forward?

You have to keep in mind that all of this is happening in the larger milieu of change in healthcare. Not everything that's changing in healthcare is a direct consequence of the affordable care act. While the insurance companies are looking at these plans and they're looking more favorably at becoming a qualified plan and getting in that market. But you know it’s like a balloon that you squeeze. We've told the insurance companies that they can only charge different rates based on a very few things: age, geography, tobacco use. But other than that, they can't really discriminate against people…So it’s like a balloon, so you squeeze down here and then it’s going to get bigger someplace else. So that's what we're sort of waiting for and watching.

Hope Kirwan left KBIA in September 2015.
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