Missouri health care exchange details unclear

Wednesday, August 14, 2013 | 2:58 p.m. CDT

ST. LOUIS — Uninsured Missouri residents planning to purchase health insurance as part of the new federal health care law are still waiting for details as the start of enrollment looms.

The insurance exchanges, which are essentially online marketplaces to compare and buy health insurance, open on Oct. 1. The federal government plans to publish details online after final certification decisions are made early next month, but some consumer advocates worry that the lack of details so far — including coverage levels and premium costs — will make it harder for residents to participate, The St. Louis Post-Dispatch reported Wednesday.

"I do think, unfortunately, that we're going to have an unusually difficult time here," said Jeanette Mott Oxford, a former Democratic state lawmaker who is now executive director of the Missouri Association for Social Welfare. "There is a lot of confusion, and people are not getting enough information about it."

The federal government is running the Missouri program after state voters in November agreed to bar state participation without legislative or voter approval. Missouri is one of 19 states that ceded control of its Affordable Care Act exchange to the federal government. Fifteen states are teaming with the federal government, while 16 states and the District of Columbia are building their own exchanges.

U.S. Sen. Roy Blunt, a Republican critic of the health care reform championed by President Barack Obama, wants federal officials to release the premium information by Aug. 26 in Missouri and the 33 other states where the federal government is involved in negotiating rates.

Blunt said families need time to plan for insurance costs, which he contends will rise under the law. Elsewhere, including in New York, officials suggest such costs will drop.

Despite the lack of details, social services agencies and community groups that work with Missouri's uninsured are preparing to disseminate information about the upcoming exchange.

The Missouri Foundation for Health, a St. Louis-based nonprofit, plans to supply more than $1 million worth of posters, wallet cards and other promotional materials about the plans. An additional $5 million in grants will be distributed to groups to hire "certified application counselors" to help with online sign-ups.

The foundation also pays the salary for the state's Affordable Care Act coordinator, retired hospital association executive Dwight Fine. Although not a state employee, he reports to Missouri's social services director.

Tonya Cain, a 40-year-old unemployed single mother from Cedar Hill, said she has no information about a program she hopes to participate in. Cain said she was forced to collect aluminum cans to sell at scrap yards to pay for pain medication after she was diagnosed with a ruptured cyst on her ovaries.

"I just know that everybody's talking about Obamacare, that it's supposed to start the first of January. That's it. No more information, no brochures," she said.

An estimated 877,000 Missourians don't have heath insurance. The federal law was designed to fill that gap through both the insurance exchanges and Medicaid, the public insurance program for the poor.

But Missouri lawmakers rejected Medicaid expansion after the U.S. Supreme Court gave states the right to decline participation.

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