Spikes in premium rates and the number of the state's residents opting to go without health insurance have spurred Missouri's governor to create a group tasked with identifying strategies that will qualify it for "innovation waivers" under the Affordable Care Act.
Gov. Mike Parson signed an executive order Wednesday, creating the Missouri Health Insurance Innovation Task Force, which is asked to identify and develop concepts that "will result in significant innovation in the Missouri health insurance market." The concepts are intended to be used to develop an innovation waiver application for the ACA.
The (Section 1332) waiver allows a state to implement innovations, provided they are at least as comprehensive and affordable as coverage provided absent the waiver, according to the Centers for Medicare and Medicaid Services (CMS). The waivers allow states to pursue alternative coverage in individual- and small-group markets. Once approved, the waivers are good for five years.
Seema Verma, CMS administrator, announced the rollout of the waivers in late 2018. CMS has expounded the virtues of consumer-driven health care plans through the waivers. Consumer-driven plans rely heavily on health savings accounts, health reimbursement accounts or other medical-payment accounts that call for patients to pay routine health expenses directly, while high-deductible plans protect them from expensive medical expenses.
"Missouri knows best when it comes to taking care of our citizens, not Washington, D.C.," Parson said in a news release. "Our health insurance market is not competitive, and there is no 'one-size-fits-all' federal solution that addresses every issue of health care access and the rising cost of insurance premiums for Missourians."
While developing the concepts to improve access to affordable health insurance, the task force must also find ways to reduce the number of state's residents who are uninsured.
In 2017, 8.4-9.1 percent of Missourians were estimated to be uninsured. And more than 13 percent of residents in 73 counties were estimated to be uninsured, according to the executive order. Additionally, more than 15 percent of their residents went uninsured in 43 counties.
Only one insurance carrier was available in each of 101 counties.
The task force will include Chlora Lindley-Myers, director of the Department of Insurance, Financial Institutions and Professional Registration, (or her designee) who will serve as the chairperson; two members each from the state House of Representatives and state Senate; an insurance producer (currently selling health insurance in Missouri); a consumer representative as recommended by the Missouri Foundation for Health and the Health Forward Foundation; a member representing Missouri's hospitals and providers; four representatives of insurance companies; and other members who Parson may appoint.
The task force is to hold its initial meeting soon after a quorum of appointed members has been established. Neither times, dates, nor places for the meetings have yet been established.
The chairperson of the task force is to submit a report to Parson no later than Jan. 31, recommending a course (or courses) of action to obtain the waiver.
"The report shall include all such information the task force believes necessary for the governor and General Assembly to consider, evaluate and authorize the submission of a Section 1332 waiver application by the Department of Insurance, Financial Institutions and Professional Registration on behalf of the State of Missouri," according to Executive Order 19-13.