NYT Profile Missouri Health Exchanges as “Covert”
August 3, 2013

Published: August 2, 2013 7 Comments

JEFFERSON CITY, Mo. — Looking for the new health insurance marketplace, set to open in this state in two months, is like searching for a unicorn.

Colorado Presses for Uninsured to Enroll
In contrast to Missouri, Colorado is embracing Obamacare. The health insurance marketplace is advertising on TV, radio and public transit and emissaries are traveling the state to explain how it will work.

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Steve Hebert for The New York Times
David R. Griggs, who owns a carpet store in Columbia, Mo., said he has not “heard a word about” insurance exchanges.
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The marketplace, or exchange, being established by the federal government under President Obama’s health care law has no visible presence here, no local office, no official voice in the state and no board of local advisers. It is being run like a covert operation, with no marketing or detailed information about its products or their prices.

While states like Colorado, Connecticut and California race to offer subsidized insurance to their citizens, Missouri stands out among the states that have put up significant obstacles. It has refused to create an insurance exchange, leaving the job to the federal government. It has forbidden state and local government officials to cooperate with the federal exchange.

It has required insurance counselors to get state licenses before they can help consumers navigate the new insurance market. And, like many states, it has refused to expand Medicaid.

“It’s like running an obstacle course every day of the week, but the course changes from day to day,” said Herb B. Kuhn, president of the Missouri Hospital Association, a strong advocate of expanded coverage.

State Senator Rob Schaaf, the Republican author of a 2012 ballot measure that prevented the state from setting up its own insurance exchange, said: “We can’t afford everything we do now, let alone provide free medical care to able-bodied adults. I have a philosophical problem with doing that, and I’m also worried about our country’s financial situation.


Jones Wants Koster to Appeal Contraception Exemption Ruling
March 21, 2013

Tim Jones(AP) — Missouri House Speaker Tim Jones asked the state’s attorney general Wednesday to appeal a federal judge’s ruling striking down the state’s contraception insurance exemption for people with moral objections.
Jones sent a letter to Democratic Attorney General Chris Koster urging him to appeal the ruling on grounds of religious freedom and to challenge a policy by President Barack Obama’s administration that requires insurers to cover birth control at no additional cost to women.
“Without (the state’s exemption), numerous Missouri citizens, businesses, and religious organizations will be forced to either pay massive fines or provide insurance coverage for their employees for procedures that run counter to their religious beliefs,” Jones, R-Eureka, said in his letter to Koster.
Missouri’s Republican-led Legislature passed the measure last year in response to Obama’s contraception policy. The overturned law allowed individuals, employers and insurers to cite religious or moral exemptions from mandatory insurance coverage for abortion, contraception and sterilization.
Democratic Gov. Jay Nixon vetoed the measure and said it was unnecessary because Missouri already has strong religious exemptions in its insurance laws. But Republicans and a few of Nixon’s fellow Democrats overrode the veto last September, automatically enacting the legislation.
A U.S. District Court judge struck down Missouri’s law last week and said it ran contrary to the provisions of Obama’s health care law. The judge noted that federal laws takes precedence over conflicting state laws.
The spokeswoman for the attorney general’s office, Nanci Gonder, said Wednesday the office has not decided whether to appeal

Battle for Control aid KC Hospital Intensifies
March 5, 2013

The battle for control of one of Kansas City’s biggest hospitals, North Kansas City Hospital, intensified Tuesday.

The Hospital Board of Trustees asked a Clay County Court to grant them an injunction. They are trying to stop the North Kansas City Mayor and Council from adding more members to the board. Additional board members could affect the direction of the hospital,, prompting a potential sale

The hospital fears ‘Northtown’, as the city is known, wants to sell the hospital to a for-profit company.

The City says it wants to look at the future. It says rising health care costs are making stand-alone hospitals, like North Kansas City, vulnerable in the future.

“Saint Luke’s Health System of Kansas City (non-profit), BJC HealthCare of St. Louis (non-profit), CoxHealth (non-profit) of Springfield, Mo., and Memorial Health System (non-profit) of Springfield, Ill. recently entered into an alliance. Individually, they each had revenues exceeding $1 billion, much greater than North Kansas City Hospital,” the city said in a late afternoon statement.

In its request for an injunction, the hospital’s attorney says North Kansas intend to “pack” the hospital board in an effort to take control.

Board members are nominated and elected by the Mayor and City Council. It has been that way since Northtown voters approved creating the hospital in 1954.

The board now has 11 members. Four, however, are at or near the end of their terms.

The lawsuit accuses the city of planning to put new potential nominees to a ‘litmus test”, support for looking at a sale of the hospital.

Even if all four new memberfs favored selling the facility, that would not be a majority.

State law, however, permits hospitals, like North Kansas City, to have up to 15 Board Members. If the city would name four additional board members the total of new members would be eight, one more than needed to control the board.

Hospital CEO Peggy Schmitt says the board room power play has not affected patient care at North Kansas City Hospital. She, however, claims patient care could be affected if the facility is sold to a for-profit hospital company.

Two Clay County lawmakers, House Democrat Jay Swearingen and Republican Senator Ryan Silvey have filed bills to help the Hospital Board. The bills would change the status of the hospital and take any North Kansas City control of the facility away.

The hospital says it has 500 physicains on staff, many more area doctors are credentials to practice there. The hospital also says it employs 3,000 people

Kansas Medicaid Waiver Approved
December 7, 2012

(AP) – Kansas Gov. Sam Brownback says federal officials have granted the state permission to overhaul its Medicaid program.

The decision by the U.S. Department of Health and Human Services was announced Friday. It allows Kansas to turn the $2.9 billion-a-year program for the needy over to three private insurance companies in January as planned.

The state already has awarded three-year contracts to the companies. Medicaid covers medical services for about 395,000 poor, disabled and elderly Kansans.

Brownback’s administration argues that moving all Medicaid participants into managed care will improve services while controlling the state’s costs.

Kansas needed HHS to waive some of its rules for the overhaul to proceed because the federal government provides the majority of funds for states’ Medicaid programs.

Health Care Expert Says Kansas & Missouri Resistance to Health Exchanges May Backfire
November 19, 2012

A policy analyst for the Missouri Foundation of Health, Thomas McAuliffe, says the bid to resist establishing on-line health care exchanges in Kansas and Missouri may lead to a larger role for the federal government, not a smaller one.
In a KMBC interview, McAuliffe says it will now be Washington, not Missourians or Kansans, that will set up exchanges.
“By ceding control to the federal government they have, by example ceded all state control of setting up the exchange, setting up prices, catering to the resources of our state, to the federal government,” McAuliffe said in a KMBC TV interview.
Both Kansas Governor Sam Brownback, a Republican and Missouri Governor, Democrat Jay Nixon have said they will not establish the exchanges.
Washington is now expected to step in during 2013 and create the health care exchanges for them .
Those exchanges, said McAuliffe, function in the same way a on-line service works for picking out an airline for a trip.
The customer chooses the private plan they think best fits their insurance needs. He says the new exchanges are required to post costs and explain the proposed coverage in understandable language.
McAuliffe called the potential increase of the federal footprint in states like Missouri and Kansas for resisting the plan, it the ‘ironic’.
Critics often call the wide-ranging health reforms enacted in the president’s first term as ,’Obamacare’.
Missouri Governor Nixon sent a letter to Health and Human Service Secretary Kathleen Sebelius telling her Missouri law prohibits the state-establishment of a health exchange.
Brownback told Kansas Insurance Commission Sandy Praeger he would not sign off on a Kansas on-line exchange because the ‘Obamcare’ law is a federal over reach.
McAuliffe says this month’s approval by voters of a ban on setting up a health care exchange without the approval of the legislature or a vote of the people, doesn’t change much in Missouri. It just re-affirms the sentiment of voters.
McAuliffe says after the United State Supreme Court upheld much of the law, Washington waited for the results of this months election before accelerating the new health care law provisions.
Nows that is over, he expected the pace of implementation to continue to increase.
Many of the provisions involving on-line health care exchanges are supposed to be ready by January 1, 2014.