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Health care marketplace information scarce

By Evan Millward, Weekend Anchor/Reporter, evanm@kmiz.com
Published On: Dec 24 2013 06:40:45 AM CST
Updated On: Sep 19 2013 01:31:02 AM CDT
COLUMBIA, Mo. -

Enrollment in Missouri's new health insurance marketplace opens within two weeks.

It's the first major part of the 906-page Affordable Care Act (ACA), otherwise known as "Obamacare."

Because of the ACA, nearly 800,000 uninsured Missourians -- 16 percent of the state's population -- will be eligible for coverage through the marketplace.

If someone does not already have insurance or does not have the option to purchase it from their employer, they will be able to compare and buy insurance all in one place online.

Despite an enrollment process that is supposed to be easy, getting information ahead of time is not.

The online marketplace allows people to customize their plan or pick the best one to fit a certain budget.

It will be available Oct. 1, but until then, do not try looking for what the plans will cover or even which companies will provide them.

"It's felt really overwhelming, but at the same time, when we started this in April, we had 170 days to October 1st and we're down to less than 14," said Ryan Barker of the Missouri Foundation for Health.

The Cover Missouri Coalition is tasked with helping Missourians enroll, but even they have to move forward without specifics, which is something difficult to do when facing a skeptical public.

"We have really armed the community organizations with information and resources that they can be out there working with consumers and small businesses and really helping them," said Barker.

Here is what information is currently available to the public:

If you are an individual making less than $45,960, you qualify for tax credits on your premiums or monthly payments.

For a family of four, that cutoff is $94,200.

Some things to have ready when you start the enrollment process:

  • Estimate your household income for next year
  • Decide how much you can afford to pay for health insurance each month
  • Gather basic information about your employer
  • Have questions ready about different plans

Details about those plans are not public yet, but consumers will be able to choose from four plan levels: bronze, silver, gold and platinum.

More or less, they will all cover the same things. The difference is if you pay more per month, you will pay less for doctor visits or medical procedures.

"It is a little frustrating that we don't know information about all of the insurance companies participating," said Barker.

A lack of participation from companies could be a concern, but at least one other state won't have any. West Virginia has just one insurer in its marketplace.

Since there is not a list of companies participating in Missouri yet, ABC 17's Evan Millward called all major insurance companies that do business in the state.

Anthem Blue Cross and Blue Shield was the only company that said it would take part on Oct. 1. Other major companies -- Assurant, Humana, United Healthcare and Cigna -- said they are holding off this year.

However, insurance professionals say smaller and more local insurers will likely jump into the marketplace.

"We're expecting that this first year is not going to be perfect ," said Barker. "We're going to have some bumps along the way."

Missouri has received nearly $22 million in grants from the federal government to start implementing the marketplace and educating residents about it.

Missouri's marketplace will be run by the federal government after both state lawmakers and voters said no to a state-run option.

The system will be play-or-pay, meaning next year, there will be penalties for not having insurance. The penalty fee will be one percent of income or $95 per adult and $47.50 per child, whichever is highest. That fee will then increase in 2015 and again in 2016.

There are exemptions to the mandatory health insurance, including religious reasons, people making too little to file a tax return and undocumented immigrants.

There is no rush to enroll in the marketplace. Once it goes live Oct. 1, anyone who enrolls before Dec. 15 will have coverage starting Jan. 1, 2014. After that, there is a one month delay, with enrollment closing March 31, 2014.

ABC 17 News has launched a special Health Care Reform section. On abc17news.com, you'll find all of the stories we do on the issue, plus frequently asked questions, ways to find help, exclusive videos and more.

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