How the federal health law will affect Missouri

Monday, January 28, 2013 | 4:44 p.m. CST

The way that some Missouri residents buy health insurance will change this fall as a result of a federal health care law enacted by President Barack Obama. The law attempts to reduce the number of people without health insurance by allowing them to comparison-shop for private insurance policies through an online marketplace called an exchange. Government subsidies will be available for some of those who cannot afford the premiums. The federal law also offers additional money to states that expand their Medicaid health care program for low-income adults.

Here are answers to a few common questions:

How many people are uninsured in Missouri?

Missouri has about 857,000 residents without insurance, or about 14.5 percent of the population, according to the most recent estimates from the U.S. Census Bureau.

How many Missouri residents are covered by Medicaid?

More than 888,000 adults and children are enrolled in Missouri's Medicaid program.

Who will oversee the health insurance exchange in Missouri?

The federal government will run Missouri's health-insurance exchange. The Republican-led state legislature declined to pass legislation that would have allowed the state to run its own insurance exchange. Voters in November approved a ballot measure prohibiting the governor or his administration from taking any steps toward establishing an online health insurance exchange unless specifically authorized to do so by a state law or vote of the people.

When does the insurance exchange begin?

Open enrollment in the insurance exchange starts Oct. 1, and the exchange is expected to be fully operational by Jan. 1, 2014.

Is Missouri expanding its Medicaid program as encouraged by the federal health care law?

That hasn't been determined. Democratic Gov. Jay Nixon has proposed to do so, but Republican lawmakers have expressed opposition to a Medicaid expansion. Nixon's administration estimates that nearly 260,000 additional people could join the Medicaid rolls in fiscal year 2014 if eligibility for low-income adults expands to the levels allowed under the federal law. 

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