Missouri Health Insurance

Health insurance in Missouri

● Missouri enrollment is through subsidized exchange at the federal level HealthCare.gov.

● The open enrollment for 2021 health plans is from 1 November to 15 December 2020. Outside of that window, residents with qualifying events can sign up or make changes to their coverage.

● Short-term health plans can be sold in Missouri with initial plan terms of up to six months.

● Eight insurers offer individual market plans for 2021, compared to seven in 2020.

● Nearly 203,000 Missourians signed up for 2020 coverage through the Missouri exchange.

● Missouri voters approved the ACA's Medicaid expansion in the 2020 primary election; coverage is expected to take effect by mid-2021.

● More than 1.2 million Missourians are enrolled in Medicare.

This page is dedicated to helping consumers quickly find health insurance resources in the state of Missouri. Here you will find information about the many types of health insurance coverage available. You can find the basics of the Missouri health insurance market and the next open enrollment period; a brief overview of Medicaid expansion in Missouri; a quick look at the availability of short-term health insurance in the state; statistics on state-specific Medicare rules; as well as a collection of health insurance resources for Missouri residents.

Missouri's health insurance marketplace

Missouri uses the federally subsidized market, which means residents will HealthCare.gov through HealthCare.gov if they want a plan through exchange.

Open enrollment for 2021 health plans runs from November 1, 2020 to December 15, 2020 in Missouri. Outside of that window, Missouri residents can still sign up or make changes to their coverage if they experience a qualifying event.

Three insurers - Oscar Health, SSM Health Insurance and Cox Health Systems joined the exchange for 2020 - bringing the number of insurers to seven. And by 2021, Blue KC (BCBSKC) is returning to the northwest part of the state, offering exchange and out-of-exchange plans in 30 counties (the same service area they covered before 2018; Blue KC left the ACA-compliant individual market at the end of 2017). So there are eight insurers offering individual market plans to Missour, on- and off-exchange, for 2021 (map of the coverage area expected here).

The current seven insurers have proposed an overall average rate increase of 4.7% for 2021. In addition to Blue KC's return to the exchange, Medica and Anthem are also expanding their coverage service areas for 2021.

Missouri enrollment in qualified health plans

As in most states, enrollment in the Missouri exchange peaked in 2016, when 290,201 Missouri residents enrolled in private plans through the Missouri health insurance market. Enrollment decreased in 2017, 2018, and again in 2019, when only 220,461 people signed up.

Enrollment fell again in 2020, with 202,750 people enrolled in the plans through the health insurance market during the Missouri 2020 open enrollment period.

Missouri has a robust small-group health insurance market (covering people employed by companies with up to 50 employees). All new small-group plans are fully ACA compliant, but are purchased directly from health insurance companies, as opposed to exchange (health insurance companies in Missouri no longer provide certified small business plans for the exchange).

Medicaid expansion in Missouri

In 2020, Missouri voters went to the polls to support the expansion of Medicaid eligibility in Missouri. In the August 2020 primaries, about 53 percent of voters said Yes to a Medicaid expansion amendment.

When the Medicaid eligibility expansion takes effect in Missouri, an estimated 230,000 Missourians will be eligible for coverage again. Until the expansion, there are 113,000 low-income residents still trapped in a coverage gap, with no realistic access to the health coverage they need.

Short-term health insurance in Missouri

Missouri does not follow new federal regulations on short-term health plans. Instead, state regulations limit short-term health insurance plans to terms of no more than six months. The state does not limit short-term plan renewals.

Missouri lawmakers had considered a bill to extend the plans in the short term, but it did not pass.

Missouri and the Affordable Care Act

Missouri resisted the implementation of the Affordable Care Act, opting for a federally facilitated exchange and declining Medicaid expansion. The state favored Trump in the 2016 presidential election, with 57.1% of his constituents choosing the Republican nominee, who campaigned with a promise to repeal Obamacare.

Yet despite Trump's popularity in Missouri, the Show-Me State has seen improvements in access to health care on par with the national average since the Affordable Care Act took effect. Missouri's uns insured rate, according to U.S. Census data, was 13 percent in 2013. It has gradually declined over the next three years, reaching 8.9% by 2016. But it had grown to 9.4% in 2018 (there was a nationwide increase in the uns insured rate under the Trump administration).

As of 2020, nearly 166,000 Missouri residents received premium grants to offset the cost of their individual market health insurance coverage. Grants averaged $563/month, which covered the vast majority of the average pre-grant premium costs ($631/month).

In addition, people with pre-existing conditions no longer face exclusion riders, above-standard rates, or rejected applications in the individual market, nor do they face waiting periods for pre-existing conditions on employer-sponsored health insurance plans. All this is the result of the ACA and its fundamental health care reforms.

Missouri and the Affordable Care Act

Missouri balked at the Affordable Care Act. He refused to implement a state-run market, rejected medicaid expansion (until voters took over the issue), and passed a law to limit consumer care; however, a court ruling blocked law enforcement.

In the 2010 U.S. Senate vote on the ACA, Senator Claire McCaskill, a Democrat, voted "yes," while Senator Christopher Bond, a Republican, voted "no." Republican Senator Roy Blunt replaced Bond in the Senate.

Blunt voted against the ACA as the U.S. representative from Missouri in 2010, and consistently voted against the ACA and similar reform measures, and in favor of bills that would unveil the ACA.

McCaskill defended the ACA, but lost his 2018 re-election candidacy to Josh Hawley, so both Missouri senators are now Republicans. Hawley campaigned with a promise to protect people with pre-existing medical conditions, but as Missouri's attorney general, he joined in a lawsuit that would eviscerate the ACA, including its pre-existing protections of conditions. Hawley said his plan to support the cause was to overturn the ACA and replace it with a new health care bill once he was in the Senate. It is noteworthy, however, that none of the GOP laws that were considered in 2017 to repeal the ACA would adequately protect people with pre-existing conditions, and since then no GOP lawmaker has proposed anything like comprehensive protections for people with pre-existing conditions (there is no way to adequately protect people with pre-existing conditions unless you have a community rating at the market level , coverage for essential health benefits on all plans, guaranteed coverage and grants to make coverage accessible; the ACA can be improved, but its current consumer protections cannot be eliminated without harming people with pre-existing conditions).

U.S. representatives from Missouri voted 6-3 against the ACA in 2010. Missouri has since lost a Seat in the House, and since 2020 Republicans have a 6-2 majority.

Republicans hold large majorities in both the House and Senate in Missouri, and are generally opposed to Obamacare. In 2016, former U.S. Navy SEAL Eric Greitens (a former Democrat, now a Republican), won the Missouri governorship elections and took office in January 2017. Greitens opposed medicaid expansion because of the cost to the state (states pay 10% of the cost, while the federal government pays 90%).

Greitens was only in office until mid-2018, when he resigned amid multiple scandals. Lieutenant Governor Mike Parson took over the governor's office at that point, and the next election will take place in 2020. One of Parson's first acts as governor was to eliminate Medicaid funding for preventive care obtained at Planned Parenthood.

Does Missouri have a high-risk pool?

The Missouri Health Insurance Pool (MHIP) was created in 1991 to provide health insurance for people who were denied coverage in the private individual insurance market because of their medical history.  But medical history is no longer an eligibility factor for private health insurance, making high-risk pools largely useless now that the ACA has been implemented.

In 2013, the Missouri Legislature approved SB262, which allowed MHIP to cease operations on January 1, 2014 and members of the transition to coverage in the private market.

Medicare coverage and enrollment in Missouri

Enrollment in Missouri Medicare reached 1,247,001 by August 2020. You can read more about the most popular Medicare plans in Missouri in our state guide, which includes details about Medicare Advantage, Medigap, and Medicare Part D.

Missouri Health Insurance Resources

● Missouri Department of Insurance (oversees and regulates health insurance plans, as well as brokers and agents who sell plans)

● Missouri HealthNet (Medicaid)

● Missouri State Health Insurance Assistance Program (CLAIM) for Missouri residents with Medicare benefits.

● Medicare Rights Center (a nationwide resource that includes a website and call center and can provide information and assistance on a wide range of Medicare-related issues).