Missouri

Over the past couple of months I've compiled a master spreadsheet breaking out enrollment in ACA plans (Qualified Health Plans & Basic Health Plans), Medicaid/CHIP coverage (both traditional & via ACA expansion) and Medicare (both Fee-for-Services & Advantage) at the Congressional District levels.

With the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which recently passed, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.

USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.

It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

Via the American Society of Anesthesiologists:

Anthem Blue Cross Blue Shield Won’t Pay for the Complete Duration of Anesthesia for Patients’ Surgical Procedures

CHICAGO – In an unprecedented move, Anthem Blue Cross Blue Shield plans representing Connecticut, New York and Missouri have unilaterally declared it will no longer pay for anesthesia care if the surgery or procedure goes beyond an arbitrary time limit, regardless of how long the surgical procedure takes. The American Society of Anesthesiologists calls on Anthem to reverse this proposal immediately.

Anesthesiologists provide individualized care to every patient, carefully assessing the patient’s health prior to the surgery, looking at existing diseases and medical conditions to determine the resources and medical expertise needed, attending to the patient during the entire procedure, resolving unexpected complications that may arise and/or extend the duration of the surgery, and working to ensure that the patient is comfortable during recovery.

The Missouri Insurance Dept. has posted their preliminary 2025 single risk pool filings for the individual and small group markets.

Not a whole lot stands out to me other than SSM Health Insurance apparently dropping out of the states indy market and a new carrier, Bankers Reserve Life Insurance, newly joining it.

At the same time, the Missouri small group market appears to be losing two carriers (or three depending on your POV): Aetna Health, Aetna Life and Cigna Health & Life are all missing from the 2025 filing summaries as well as the federal Rate Review database.

In any event, the MO individual market is looking at average premium reductions of 1.7% if approved as is, while small group plans are likely to increase by about 7.9% overall.

As always, these are subject to state regulatory review and approval.

via the Centers for Medicare & Medicaid Services (CMS):

Thanks to the Biden-Harris Administration’s efforts to strengthen maternal health, an estimated 641,000 Americans annually are now eligible for essential care for a full year after pregnancy.

Back in July I posted Missouri's preliminary 2024 rate filing requests from individual & small group market carriers; the weighted average across all 9 carriers on the individual market was 4.3%, while it was 6.6% for the small group carriers.

Yesterday the Missouri Insurance Dept. posted the final/approved filings along with this press release:

Missouri Department of Commerce and Insurance releases health insurance rates for 2024 with more choices for Missourians

• Missourians should shop around when looking for health insurance coverage on the individual market; most will find they have many choices for plan year 2024

Jefferson City, Mo – The Missouri Department of Commerce and Insurance (DCI) announces the release of final health insurance rates for Missouri’s 2024 individual market. 

The Missouri Insurance Dept. has posted their preliminary 2024 single risk pool filings for the individual and small group markets.

Not a whole lot stands out to me other than Cigna apparently dropping out of the states indy market and Humana pulling out of the small group market. Otherwise, neither market has rate changes which seem terribly surprising--they come to a weighted average increase of 4.3% for individual market plans and 6.6% for the small group market.

As always, these are subject to state regulatory review and approval.

Most of the time when another state extends postpartum Medicaid coverage from two months to a full year, as allowed for under the American Rescue Plan from two years ago, I simply cross-post the official press release from the Centers for Medicare & Medicaid Services.

This time, however, I have a heads up...it isn't official yet, but it looks like Missouri and Alaska are about to become the 33rd & 34th states to do so. Via David Lieb of the Associated Press:

JEFFERSON CITY, Mo. (AP) — Lower-income new mothers could gain a full year of Medicaid health-care coverage in Missouri under legislation given final approval Friday as part of a national push to improve maternal health.

Missouri's insurance dept. has released the proposed 2022 rate filings for both the individual and small group markets. Overall, individual market carriers are requesting rate hikes of 11.1% on average, while the small group market carriers are asking for an average 11.8% increase.

It's worth noting that each market has a new entrant for 2022: UnitedHealthcare is joining the individual market while National Health Insurance is jumping into the off-exchange Small Group market.

UPDATE 11/03/22: Now that the 2023 Open Enrollment Period has officially launched, the Missouri Insurance Dept. has finally posted the final/approved rate changes. They've made some very minor tweaks to a few of the individual market filings, but that just brings the weighted average down around 0.1 points to 11% even.

The small group market filings were approved as is.

As I noted last night, thanks to the federal Rate Review website finally being updated to include the final, approved 2022 rates for both the individual and small group markets in all 50 states (+DC), I've been able to fill in the missing data for my annual ACA Rate Change Project.

As I note there, the overall weighted average looks like it'll be roughly +3.5% nationally.

Normally I write up a separate entry for both the preliminary and approved rate changes in each individual state, but it seems like overkill to create 14 separate entries at once. Besides, in many of these states there's been few if any changes between the preliminary and approved rate changes.