As deadline nears, Boone County residents show interest in health exchange

Saturday, December 21, 2013 | 6:00 a.m. CST; updated 9:33 p.m. CST, Sunday, December 22, 2013

COLUMBIA — Slightly more than two out of every 10 Boone County residents younger than 65 don't have health insurance, a rate that's slightly higher than the state average.

As the new year draws closer, those without insurance have only a few more days to enroll in subsidized health insurance plans under the Affordable Care Act. To be covered on Jan. 1, individuals have to sign up by Monday.


As the deadline approaches to enroll in health insurance plans on the new exchange, some are feeling a substantial impact — both positive and negative. Here's a look at what the new federal health care law means for the family, the patient, the smoker, the Medicaid winner and loser, the young adult, the self-employed, and the small-business owner. (This story is available to readers with a Missourian digital membership.)

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Clinics and social service agencies in Boone County said that in the past three weeks, they have helped more people learn about and enroll in health insurance plans than in any period of time since the website was launched on Oct. 1.

"More and more Missourians are seeing potential in the marketplace," said Thomas McAuliffe, a health policy analyst at the Missouri Foundation for Health.

But he said many people, especially those who tried to log on to when it first became available and experienced the site's notorious glitches and long wait times, are still skeptical.

"This is the Show-Me State," McAuliffe said. "Getting people to come back to the website has been tough."

However, at least in Boone County, data show that residents are expressing interest in buying health insurance on the exchange.

At the Family Health Center on West Worley Street, spokesman Aaron Swaney said staff and volunteers have helped more than 100 Boone County residents submit applications for coverage in the past three weeks. As of Tuesday, Swaney said, 36 of those applicants had purchased insurance plans through the health care marketplace.

Jeremy Milarsky, spokesman for Columbia health care consulting firm Primaris, said his organization has helped about 75 people enroll in health insurance through the exchange. Milarsky said that number does not reflect cases in which people started applications at the Primaris office then completed the process at home.

Swaney said many applicants who don't purchase insurance fall into what he and others call the Medicaid gap. These applicants don't make enough money to qualify for a subsidy that would help them pay for insurance purchased in the federal marketplace, but for a variety of reasons, they don't qualify for Medicaid, the federal government's health program for low-income families.

Even if the Missouri legislature decides to change the guidelines to make more people eligible for Medicaid, the Missouri Foundation for Health's McAuliffe said, low-income adults without children still won't qualify.

"If you make $5.25 an hour and you're uninsured today, you'll still be uninsured on this day a year from now. And that's troubling," McAuliffe said.

Of the roughly 800,000 Missourians without health insurance, McAuliffe said, he estimates that about half will get some kind of subsidy to help pay for coverage they buy through the federal exchange. Of the remaining 400,000, he said, about 200,000 fall into the Medicaid gap.

Emily Young, community services supervisor at Central Missouri Community Action, said she and her staff have had what she called difficult conversations with people who go through the application process only to find that they make too much money to get Medicaid and too little to get a subsidy.

"It's really tough when you sit down with somebody and you have to tell them they've fallen below that line," Young said.

Supervising editor is John Schneller.

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