Missouri groups promote Affordable Care Act's insurance exchange

Wednesday, September 25, 2013 | 9:47 p.m. CDT; updated 5:39 p.m. CDT, Thursday, September 26, 2013

COLUMBIA — With open enrollment in the new federal health insurance marketplace set to begin on Oct. 1, several organizations are preparing to help Missourians understand both coverage requirements mandated by the Affordable Care Act and options available in the marketplace.

In a Wednesday conference call, Michelle Miller, liaison for Missouri Foundation for Health Public Policy, outlined the ongoing work of the Cover Missouri Coalition, a project that started with a handful of organizations in spring 2013 and ramped up its membership to 150 organizations with about 3o0 individual members last month following a statewide summit.

In late August, the Missouri Foundation for Health granted $4.9 million to 16 Cover Missouri-affiliated organizations, who will promote awareness about the health insurance exchange through a combination of community outreach and one-on-one certified application counselors. This outreach will supplement the work of federally funded navigators, who are qualified to advise and enroll people in the exchange and are being funded by a $1.7 million federal grant.

Like navigators, certified application counselors are qualified to help people enroll in the marketplace and must have a federal license to do so. Missouri law also requires that both navigators and certified application counselors have an additional state license to help anyone enroll in the exchange.

In addition to helping people enroll, Miller said Cover Missouri's partners are distributing informational materials about the exchange's requirements and resources.

"Regardless of how people feel about the law overall, through our Cover Missouri work, we are really seeing a thirst for quality fact-based information, just 'what's going on' and 'how does this affect family or my business,'" Miller said. 

While the federal government has yet to release specific details about the plans available in the exchange, a report issued Wednesday by the federal Department of Health and Human Services projected premiums to be lower than previously expected.

The report broke down what Missourians might expect their monthly premiums to be. For example, the average premium per month for a single 27-year-old in Missouri with an income of $25,000 would be roughly $220 for the "second lowest cost silver plan" before tax credits. After tax credits, that person's average premium would be $145. The average premium per month for a family of four with an income of $50,000 on the same plan would be roughly $798 before tax credits and $282 after the credits.

The open enrollment period runs until March 2014. Those not enrolled in a plan by Dec. 15 will have to pay one-twelfth of an annual federal income tax penalty for each month in which they lack insurance.

Navigator Program Manager Jeremy Milarsky of Primaris Healthcare Business Solutions, which is also running a certified application counselor program, said anyone currently uninsured should go ahead and file a marketplace application even if they can't find a plan that costs less than 8 percent of their income. In that case, they would qualify for an exemption from the penalty.

"The system is designed to help you find an affordable plan," Milarsky said.

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