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federal payment rates would Medicaid expansion, according free up state money currently to Consumer Reports. spent on these efforts. Additionally, a family of four with an annual income of up to Medicaid expansion in $31,155 will also qualify. context Originally, ACA or the health For Missouri, analysts project care law required all states to this would equate to expand eligibility criteria in approximately 259,499 adults their Medicaid programs with enrolling in Medicaid as a result the caveat that all federal of the expansion in 2014. This dollars from their current estimate is projected to rise to Medicaid program would be 307,542 by 2021. withheld from any states that refused. Twenty-six states filed Cost shifting hits private a joint lawsuit and two states— payers Missouri and Virginia—filed Currently, 14 percent of individual lawsuits against the Missourians now receive federal government, claiming Medicaid benefits or are that ACA was unconstitutional. uninsured. The current impact from the uninsured means that On June 28, 2012, the U.S. costs are shifted on private Supreme Court ruled that while payers' insurance premiums. ACA was constitutional, the federal government could not What this comes down to is: withhold federal Medicaid when some payers underpay dollars if a state chose not to hospitals and other health care participate in the Medicaid providers relative to the actual costs of the services provided, expansion. the costs are then passed on As a result, it is up to every to private payers. Quite state to opt in or opt out of simply, insurance premiums participating in the expansion. increase. Additionally, there are no mandates on states to make a The uninsured also pay a huge decision by a particular price. Individuals who lack health insurance historically deadline. have a lower health status than "Right now, one in seven those with insurance due to a Missourians are uninsured," lack of access to preventive said Health Care Foundation of care services and screenings Greater Kansas City outgoing for conditions that can lead to President/CEO Steve Roling. chronic illnesses. "This continues to generate lower than optimal health care As for those suffering from outcomes, including higher chronic illnesses, their vehicle rates of disease, premature to health care is usually death and more than $1 billion through the emergency room. in uncompensated care, not to The domino effect is increased costs, both mention the cost to Missouri insurance commercial and public; taxed businesses in reduced productivity. By saying yes and emergency departments that accepting the $8.2 billion in result in uncompensated care; federal funding to expand and reduced work productivity those who are Medicaid in Missouri, we can among help some of the most employed. underserved Missourians at a minimal cost to the state and According to a recent Missouri also avoid some significant Foundation for Health (MFH) pitfalls to the health care report, The Economic Impacts of Medicaid Expansion on industry." Missouri, private insurance premiums are directly Who qualifies for help? Uninsured individuals at or impacted: average private below 138% the federal Ÿ The insurance premium for a poverty level will qualify. For family of four in Missouri instance, a single person with was $12,754 in 2010 and is an annual income of up to projected to cost $14,992 $15,302 will qualify for in 2014 (this is without any changes to Missouri Medicaid). Ÿ Of the growth in Missouri insurance premiums from 2010 to 2014, cost shifting from the uninsured represents $434 of this growth. Ÿ If full effects of the expansion are realized, a family of four could expect to save $1,688 in reduced premiums from 2014 to 2020. An individual would save an estimated $610 over the same time period according to the report. "It's clear that an aggressive approach to improving access to health care is needed in Missouri—if not, premiums will continue to rise and the pool of uninsured Missourians will deepen," said Walter Wright, CEO of The Firm Insurance Group, which provides both commercial and individual lines of insurance throughout the Midwest. "What's needed is an aggressive, integrated approach that strives to look at this issue from all angles. Serious, concerted investments in education and job training programs will gradually level the playing field among some of the uninsured. Healthy lifestyle training and advocacy tailored to rural and urban communities is also key. However, the best money spent will be used to close the chasm between self sufficiency and government dependency." Missouri legislators to vote The Missouri General Assembly is expected to vote on whether or not to opt in to the Missouri Medicaid expansion in late March or April. The General Assembly is about two-thirds Republican. Health @accessHealth1 Erin Burdette Social Media Assistant Rachel Collins Contributing Writer Marjorie Langas Graphic Support Randy Leiker IT Support Tempest Wright Teen Health Editorial Assistant Editorial/Digital Photography Tonia Wright Publisher, Editor-in-Chief We want to hear from you! Let us know how we are doing on Facebook, Twitter @accessHealth1 or write: accessHealth c/o Grace Advertising 325 Broadway Lexington, MO 64067 accessHealth is published by Grace Advertising & Consulting, Inc. 325 Broadway Lexington, MO 64067 is the online arm of this print publication. A special thank you to HCF for supporting the following nonprofits in this issue: HCC of Rural Missouri Pathways Community Health MU Extension

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