ST. LOUIS (AP) — Missourians who live in rural areas are far less likely to have health insurance than those living near big cities, according to U.S. Census data.
The Associated Press examined county-by-county data for 2011, the most recent year available.
The numbers show the uphill climb facing President Barack Obama's health care overhaul in Missouri, which opted against setting up its own exchange and instead allowed the federal government to run it.
Missouri overall ranks right in the middle of the nation in the percentage of uninsured residents under age 65 — tied with Washington state at 25th with 16 percent uninsured. But in 34 of Missouri's 115 counties, one-fifth to one-quarter of non-senior residents lack health insurance. Twenty-seven of those 34 counties have fewer than 25,000 residents.
CHICAGO (AP) — Governor Pat Quinn's administration has announced Illinois will allow the one-year extension of existing health insurance plans proposed by President Barack Obama.
Friday's announcement sets Illinois apart from some other states led by Democrats. Those states rejected the president's proposal, saying it could leave many consumers with substandard coverage.
Obama announced last week he wants insurers to have the option to renew plans that would otherwise be canceled because they fall short of requirements in the nation's health law.
The proposal was meant to help the president regain credibility after his frequent promise that Americans who liked their plans could keep them.
At least 4 million Americans received cancellations notices — including about 185,000 in Illinois.
It's unclear how Illinois insurers will react. They aren't required to renew the policies.
CHICAGO (AP) - The Illinois Department of Insurance and the state's major health insurer say they are reviewing changes to the health law announced Thursday by President Barack Obama that address policy cancellations.
Obama said insurers can continue to sell policies canceled under the Affordable Care Act for at least one more year to existing customers. But insurers aren't required to continue the canceled plans.
Blue Cross Blue Shield of Illinois officials say the company is "determining next steps" and will reach out to consumers who may have new options as a result of Obama's announcement.
A spokesman says Illinois Insurance Director Andrew Boron has been in contact with federal authorities and is evaluating options, keeping in mind what's best for the state's consumers.
At least 4 million Americans have received cancellation notices.
WASHINGTON (AP) — Now is when Americans start figuring out that President Barack Obama's health care law goes beyond political talk, and really does affect them and people they know.
With a cranky federal website complicating access to new coverage and some consumers being notified their existing plans are going away, the potential for winners and losers is creating anxiety and confusion.
"I've had questions like, 'Are they going to put me in jail if I don't buy insurance? Because nobody will sell it to me,'" said Bonnie Burns, a longtime community-level insurance counselor from California. "We have family members who are violently opposed to 'Obamacare' and they are on Medicaid — they don't understand that they're already covered by taxpayer benefits.
"And then there is a young man with lupus who would have never been insurable," Burns continued. "He is on his parents' plan, and he'll be able to buy his own coverage. They are very relieved."
A poll just out from the nonpartisan Kaiser Family Foundation documents shifts in the country in the month since insurance sign-ups began.
Fifty-five percent now say they have enough information to understand the law's impact on their family, up 8 percentage points in just one month. Part of the reason is that advertising about how to get coverage is beginning to register.
"The law is getting more and more real for people," said Drew Altman, the foundation's president. "A lot of this will turn on whether there's a perception that there have been more winners than losers. ... It's not whether an expert thinks something is a better insurance policy, it's whether people perceive it that way."
The administration is continuing its efforts to influence those perceptions. On Wednesday, Obama will meet with volunteers in Dallas who are helping people enroll in health insurance plans. Cabinet officials are also expected to make stops around the country in the coming weeks to encourage people to sign up for insurance even as the website problems persist.
A look at three groups impacted by the law's rollout:
LOSING CURRENT PLAN
The Obama administration insists nobody will lose coverage as a result of cancellation notices going out to millions of people. At least 3.5 million Americans have been issued cancellations, but the exact number is unclear. Associated Press checks find that data is unavailable in a half the states.
Mainly they are people who buy directly from an insurer, instead of having workplace coverage. Officials say these consumers aren't getting "canceled" but "transitioned" or "migrated" to better plans because their current coverage doesn't meet minimum standards. They won't have to go uninsured, and some could save a lot if they qualify for the law's tax credits.
Speaking in Boston's historic Faneuil Hall this past week, Obama said the problem is limited to fewer than 5 percent of Americans "who've got cut-rate plans that don't offer real financial protection in the event of a serious illness or an accident."
But in a nation of more than 300 million, 5 percent is a big number — about 15 million people. Among them are Ian and Sara Hodge of Lancaster, Pa., in their early 60s and paying $1,041 a month for a policy.
After insurer Highmark Inc., sent the Hodges a cancellation notice, the cheapest rate they say they've been able to find is $1,400 for a comparable plan. Ian is worried they may not qualify for tax credits and doesn't trust that the federal website is secure enough to enter personal financial information in order to find out.
"We feel like we're being punished for doing the right thing," he said.
Their policy may not have met the government's standards, "but it certainly met our minimum standards," Hodge added.
"The main thing that upsets us is the president ... said over and over and over again: If you like your health plan, you will be able to keep your health plan, guaranteed."
There's a chance the number of people getting unwanted terminations may grow. In 2015, the law's requirement that larger companies provide health insurance will take effect. It's expected that a small share of firms will drop coverage, deciding that it's cheaper to pay fines imposed under the law.
Before the law's online health care markets launched Oct. 1, the administration estimated nearly 500,000 people would enroll for subsidized private insurance within the first month. Despite high consumer interest, a computer system beset by gremlins has kept most from doing so.
The administration refuses to release enrollment numbers until mid-November, when a crash program of computer fixes may be showing results. The numbers are expected to be disappointingly low; officials acknowledge as much.
A different prong of Obama's coverage expansion seems to be doing fairly well. It's an expanded version of Medicaid, embraced so far by 25 states and the District of Columbia. An informal survey of 14 of those states by The Associated Press shows that at least 240,000 people had enrolled in or applied for the expanded safety-net program as of the third week of October.
Private coverage is what interests Cecilia Fontenot of Houston, a part-time accountant in her early 60s. She has diabetes, high blood pressure and high cholesterol. Though she manages well, she has been unable to find affordable insurance. Under Obama's law, insurers will not be able to turn away people with medical problems or charge them more.
Fontenot gave up on HealthCare.gov and instead applied through a call center on Oct. 19.
"They said it may take a while because so many people had called in," Fontenot explained. "I'm a very patient person, and I'm looking forward to getting that insurance."
She wants a plan that covers a better diabetes drug than the one she can afford now by paying out of pocket. Her doctor has also recommended a high-tech imaging test for a breast lump.
WONDERING WHETHER COVERAGE WILL CHANGE
Americans are still divided over the Affordable Care Act, with negative views outweighing positives. But they also lean against repealing it. The final judgment may be in the hands of people who now have employer-provided health insurance. They're about half the population, and they've noted Obama's assurances that their coverage won't be disrupted.
Up to now, the changes for employer plans have been incremental. They tend to expand benefits, not take things away.
For example, young adults can stay on a parent's coverage until they turn 26. Employers cover women's birth control as a preventive service, free of charge. Screening tests such as colonoscopies are also free.
But cost control provisions, mainly a tax on expensive insurance plans that starts in 2018, are converging with the long-standing push by employers to tame health costs. Some companies have raised deductibles and copayments for employees, saying they need to scale back to avoid tangling with the coming tax. Others are giving employees a fixed amount of money to shop in private health insurance markets that resemble those created by the law.
Expect cutbacks to be blamed on the law. Sorting out whether that's warranted may be difficult.
"What the Affordable Care Act did was give companies a very convenient excuse to say 'Oh, gosh, we really have to get serious about insurance costs,'" said Paul Keckley, an independent health benefits consultant. "I think there's a bit of a bob and weave. The ACA was a convenient excuse for doing what (corporate) human resources departments have been calculating to do for years."
WASHINGTON (AP) — The principal contractors responsible for the federal government's trouble-plagued health insurance website say the Obama administration shares responsibility for the snags that have crippled the system.
Executives of CGI Federal, which built the federal HealthCare.gov website serving 36 states, and QSSI, which designed the part that verifies applicants' income and other personal details, are testifying Thursday before the House Energy and Commerce Committee.
The hearing comes as President Barack Obama's allies are starting to fret about the political fallout. Democrats had hoped to run for re-election next year on the benefits of the health care law for millions of uninsured Americans. Instead, computer problems are keeping many consumers from signing up through new online markets.
One House Democrat says the president needs to "man up" and fire somebody, while others are calling for signup deadlines to be extended and a reconsideration of the penalties individuals will face next year if they remain uninsured.
On that point, a change in the timeline for signing up for coverage is underway, the White House said. Consumers have until Dec. 15 to apply for coverage that's effective Jan. 1. Even though open enrollment lasts until March 31, people would face a penalty if they postpone buying coverage beyond mid-February. Calling that a "disconnect," the White House said officials will soon issue policy guidance allowing consumers to sign up by the end of March without penalty.
The focus on the contractors is a first step for GOP investigators. After the failure of their drive to defund "Obamacare" by shutting down the government, they've been suddenly handed a new line of attack by the administration itself. Administration officials, including Health and Human Services Secretary Kathleen Sebelius, are to testify next week.
Cheryl Campbell, senior vice president of CGI, suggested in prepared testimony that Congress should look beyond the contractors. HHS "serves the important role of systems integrator or 'quarterback' on this project and is the ultimate responsible party for the end-to-end performance," she said.
Overwhelming interest from consumers triggered the website problems, she said. "No amount of testing within reasonable time limits can adequately replicate a live environment of this nature," she said.
Andy Slavitt, representing QSSI's parent company, said the operation's virtual back room, known as the federal data hub, is working well despite some bugs. But his company was also involved with another part of the system, a component for registering individual consumer accounts that became an online bottleneck.
Slavitt blamed the administration, saying that a late decision to require consumers to create accounts before they could browse health plans contributed to the overload. "This may have driven higher simultaneous usage of the registration system that wouldn't have occurred if consumers could window-shop anonymously," he said.
Rep. Joe Pitts, R-Pa., chairman of the panel's health subcommittee, said he wants to focus on the administration's decision not to allow browsing, or window-shopping. That's a standard feature of e-commerce sites, including Medicare.gov for seniors. Lack of a browsing capability forced all users to first go through the laborious process of creating accounts, overloading that part of the site.
"Who made that decision? When was it made? Why was it made?" Pitts asked.
Acknowledging what's been obvious to many outside experts, the administration said Wednesday that the system didn't get enough testing, especially at a high user volume, before going live. It blamed a compressed time frame for meeting the Oct. 1 deadline to open the insurance markets. Basic "alpha and user testing" are now completed, but that's supposed to happen before a launch, not after.
The administration provided no timetable to fix extensive computer snags but said technicians are deep into the job. Its explanation, posted online in an HHS blog and accompanying graphic, identified six broad areas of problems and outlined fixes underway but in most cases incomplete.
The HHS explanation identified some bugs that have gotten little outside attention. Technical problems have surfaced that are making the application and plan-shopping functions difficult to complete. That's a concern because those stages are farther along in the signup process than the initial registration, where many consumers have been getting tripped up. The problems are being analyzed and fixes are planned.
Meanwhile, House Democrats are starting to worry aloud about persistent problems with the rollout.
Rep. Richard Nolan, D-Minn., told The Associated Press the computer fiasco has "damaged the brand" of the health care law.
"The president needs to man up, find out who was responsible, and fire them," Nolan said. He did not name anyone.
Obama says he's as frustrated as anyone and has promised a "tech surge" to fix the balky website. White House spokesman Jay Carney said the administration will be more transparent about the problems. After more than 20 days without briefing the media, HHS will start regular sessions on Thursday, he said.
In light of the computer problems, some Democrats are saying Obama should consider extending open enrollment season beyond March 31 and revisit the penalties for individuals who don't sign up and remain uninsured. Under the law, virtually all Americans must carry health insurance starting next year or face fines.
The online health insurance exchanges are now open in both Missouri and Illinois. The online marketplace is a key component of the federal health care law.
Illinois officials have set up their own marketplace at GetCoveredIllinois.gov.
Missouri voters chose to bar their government from setting up its own marketplace. So the federal government is running the exchange for Missouri residents at Healthcare.gov.
Consumers have until December 15th to sign up if they want coverage to start on January 1, but enrollment is open until March 31.
On October 1st, the federally mandated health insurance exchanges open enrollment. And that includes Missouri.
State voters passed a law last year that effectively barred the governor from setting up an insurance exchange, but that doesn't mean there isn't one.
The federal government will operate Missouri’s online marketplace, which is currently being set up. The federal website, healthcare.gov says it will be ready in time for enrollment to begin.
Under the new healthcare law, those who don't have insurance through their employers, schools, parents, a private policy or a public plan like Medicaid or Medicare will face fines next year. And many of them are expected to be young adults. The St. Louis Post Dispatch reports that 25% of young adults in the Missouri are currently uninsured.
Illinois did set up a health insurance exchange.
Residents in both Missouri and Illinois can get more information about affordable coverage at healthcare.gov.
Part time employees at one of the metro area's biggest healthcare providers may soon lose their health insurance.
The St. Louis Post-Dispatch reports that BJC Healthcare is preparing to cut health insurance benefits for employees who work less than 24 hours each week.
The paper cites two part time nurses as saying that managers and Human Resources representatives recently began informing certain employees of the plan. Hospital official declined to comment on any planned changes, but did tell the paper that they are in the process of sharing their 2014 benefits plan with employees.
The change of policy could affect thousands of workers at Barnes-Jewish Hospital, St. Louis Children's Hospital, Christian Hospital and other BJC hospitals, outpatient centers and clinics.