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Missouri Health Insurance

Missouri is one of several states who resisted the implementation of the Affordable Care Act, opting instead for a federally-facilitated exchange. While Medicaid expansion took effect in 2014 in many other states, it didn’t take effect in Missouri until 2021. The Missouri Health Insurance Marketplace was created as a part of the Affordable Care Act found at HealthCare.gov. From there, residents can access qualified plans for health insurance in Missouri and find out if they qualify for premium subsidies, Medicaid, or the Children’s Health Insurance Program known as CHIP.

The Affordable Care Act

Beginning on January 1, 2014, The Affordable Care Act (ACA), also known as Obamacare, created a system of healthcare exchanges (or “marketplaces”) to provide individuals and small employers with access to affordable insurance coverage. Missouri uses the federal exchange at HealthCare.gov for enrollment in ACA qualified health plans.

To use the system, you simply need to register for an account and complete an application, which includes questions about your family members and anticipated 2014 income.

You can enroll in marketplace health plans from the marketplace, but you may need to contact your insurer separately to make payments. If you qualify for premium credits, also known as subsidies, they can be applied to monthly premiums right away.

The federal government began to provide funding for Medicaid expansion in 2014, but Missouri was one of 13 states that continued to reject it. This changed when a unanimous supreme court ruling issued in July 2021 finally approved Medicaid expansion for Missouri. Medicaid expansion enrollment began processing in October 2021.

Do you qualify for a Missouri health insurance subsidy?

There are three main paths to federal financial help with Missouri medical insurance rates. The first is through tax credits (subsidies) that help pay for premiums on qualified marketplace health plans. The other ways are through Medicaid and CHIP.

Typically, only people who do not have other ways to get affordable health insurance can qualify for assistance. Missouri residents who already have employer-sponsored insurance or other private medical benefits are free to keep them as long as the plan qualifies under new guidelines.

The following groups of Missourians can get help paying for health insurance.

Residents who earn between 100% and 400% of the federal poverty level. This ranges from $12,760 to $51,040 per year for a single adult in 2020.
In 2021, the federal government expanded subsidies and removed the income cap for premium tax credits. Thanks to this expansion, you would pay no more than 8.5% of your annual household income on health insurance based on the price of the benchmark plan. The federal government would cover the balance through subsidies.
Children from low- to moderate-income families with an income of less than 305 percent of the poverty level, or about $72,740 for a family of four, may qualify for coverage under CHIP.

Qualifying for Medicaid

After being passed in 2021, Medicaid expansion now extends coverage to adults under age 65 with household incomes up to 138% of the poverty level. You may qualify for benefits if you earn $17,131 or less as a single adult. The income limit rises by about $6,038 for each additional person in your household Low-income residents who are aged, blind, or disabled are also eligible for Medicaid, but they’re also subject to fairly strict asset limits in order to qualify for coverage.

Some Missouri residents who earn too much money to qualify for assistance may choose to use the marketplace to purchase health insurance anyway. Insurers are not allowed to deny coverage for pre-existing medical conditions, and they must provide mandated health benefits for preventive care.

Missouri health insurance companies

These companies have qualifying marketplace plans for Missouri.

Anthem Blue Cross Blue Shield
Blue Cross and Blue Shield of Kansas City
Coventry Health and Life
Coventry Health Care

Missouri health and coverage statistics

Missouri population (2021): 6,168,187
Population 65 and older (2021): 17.3 percent
Life expectancy (2019): 77.4 years
Number of Medicaid beneficiaries (2021): 1,081,802
Number of Medicare beneficiaries (2020): 1,266,467
Estimated number of uninsured residents (2020): 595,289

Overall state health ranking: 39

Sources: Kaiser Family Foundation, U.S. Census Bureau, America’s Health Rankings 2014 report, Missouri DHSS