Missouri health insurance marketplace: history and
news of the state’s exchange

BCBS of Missouri and Bright Health offering plans for 2018; cost of CSR added to silver premiums,making other
metal levels particularly affordable

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Louise Norris
Individual health insurance and health reform authority; broker
March 22, 2018

More Missouri coverage

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    Insurance Guide
    • A guide to health insurance in
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    • Your state’s Medicaid expansion,
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    • Insurance for those over 64

Highlights and updates

  • 2018 enrollment down 4.6% from 2017
  • One insurer in 2017, but Bright Health joined in 2018
  • Average rate increase 15.6%, including added premiums to cover CSR cost
  • Cost of CSR added to silver exchange, other metal levels particularly cheap for some
  • 2018 rates and new insurer indicate death spiral no longer a danger

Missouri exchange overview

Missouri was one of the states that were less open to the Affordable Care Act. They chose not to expand Medicaid and have yet to implement a state-run marketplace. Missouri’s uninsured rate in 2017 was at 9.1%. In 2018, 188,000 Missouri residents got premium subsidies in order to try and offset the cost of their individual health insurance. Average subsidies were around $592 per month. If Missouri had opted to expand Medicaid, an estimated 293,000 people would be eligible for coverage. Due to the fact that subsidies are only available in the exchange for people whose household incomes are at least 100% of poverty, there are 87,000 Missouri residents who are in the coverage gap.


Risks in Missouri

Missouri Health Insurance Pool was enacted in 1991 in order to give residents who were denied coverage in the private market due to their medical history another option. However, thanks to the Affordable Care Act, high risk pools are largely obsolete. The Missouri Health Insurance Pool shut down in 2014.

Missouri’s Marketplace

In 2017, 243, 382 residents purchased a private health plan through Missouri’s open enrollment. Medica announced that would be join the 2018 exchange in Missouri, which makes the final number of providers four:

  • Medica
  • Anthem
  • Ambetter
  • Cigna

On average, the rate increases for 2019 was 1.6% while the premiums decreased by 5.3%.

Missouri and Medicare

In 2018, Missouri’s Medicare enrollment reached 1.2 million which is 19% of the state’s population. Of that 1.2 million, 81% enrollees qualified for Medicare on age alone while the other 19% qualify as the result of a disability. 34% of Missouri’s Medicare beneficiaries opted for a Medicare Advantage over traditional Medicare plans. In the past, Medicare has paid around $8,924 annually per enrollee in Missouri. The state ranks 16th in the nation in overall Medicare spending at $9.6 billion annually.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.