The pursuit of affordable health insurance for all in Missouri is expected to get even harder in the coming year. A new report from the Congressional Budget Office estimates premiums will increase by 31 to 54 percent in 2019 largely because of the decision to eliminate federal subsidies for low- and middle-income people to help them pay for coverage, and uncertainties about the future of the Affordable Care Act.
Elliot Fishman, senior director for health policy for the advocacy group Families USA says in states that opted to expand Medicaid, people will fare slightly better, but …
“Missouri did not,” he laments. “Expanding Medicaid tends to help to reduce premiums for people with higher incomes because it takes what is a relatively high-cost population out of the [health insurance] marketplaces and puts them into Medicaid.”
Earlier this month, Missouri lawmakers voted to allow women to receive Medicaid coverage for more than a year after giving birth to pay for substance abuse and mental health services. But it must be signed by the governor, and the state will need a waiver from the federal government to enact the change.
Missouri is one of 20 states in a preliminary injunction against the Affordable Care Act last month, arguing that requiring individuals to have health insurance is no longer legally justifiable.
Regardless of the projected premium increases and rocky road in Missouri for the ACA, the number of uninsured individuals declined by 31 percent between 2013 and 2016. Fishman says it’s important to note that the CBO is an objective source – and the agency blames the premium hikes on changes made under the Trump administration.
“The CBO is really the most authoritative voice on these questions, and it reports ultimately to Congress,” he says. “It has a Republican-appointed director, and is really an unimpeachable and objective source on that question.”
Eighty-eight percent of the 213,000 people covered through the Health Exchange in Missouri receive a subsidy to help offset their premium costs, which also increases the overall cost to the federal government.