“Building upon our tax equity and portability successes from last year, we are now in a position to continue making market-based reforms to improve access to affordable coverage for those who are unable to be medically underwritten and to low-income individuals. It is also time that Missourians be given the information necessary to be informed consumers and not just participants in their health care. We have a right to know the cost and quality of health care before those services are provided,” said Rep. Ervin. “This legislation takes steps to change things, to move the state in the right direction, to redirect our state’s health care policies to meet the needs of its citizens instead of the needs of employers, government, insurers, and providers.”
Ervin believes that people have the right to know what health care costs and have some idea of the quality of that care before the care is provided. “All of us, at one time or another has driven across town to save a penny or two per gallon of gas or spent time clipping coupons, yet we don’t think twice about the price of health care,” Ervin said. “As consumers of health care we act irrationally, especially when it is paid for by a third party. This is largely due to the lack of price and quality information available to consumers.”
Ervin’s plan ensures that people have the right to request an estimate of the costs of their care in non-emergency situations before that care is provided. “It is not that we don’t care about what something costs or how good our doctor is, but simply that we have never been given the opportunity to find out. Let’s face it, we have a health care system that is price blind and quality silent, patients demand and deserve better than that.”
The Missouri Health Insurance Pool
Under Rep. Ervin’s plan, the medically uninsurable will be provided affordable health insurance through the high risk pool known as the Missouri Health Insurance Pool (MHIP). The MHIP serves individuals who have medical conditions that insurers won’t provide coverage to in the individual health insurance market. These individuals typically do not qualify for public assistance and do not have an employer health insurance plan available to them. It is estimated that one to two percent of Missouri’s population is considered medically uninsurable.
Currently, individuals qualifying for the high risk pool pay 150% of the standard market rate for coverage. Ervin’s bill would lower that rate to the standard market rate for lower income enrollees and cap the rate at 125% of the standard market rate for higher income enrollees. The plan also authorizes the MHIP to create a low-income premium subsidy program to assist low-income enrollees.
Small businesses find the cost of providing employees with employer-sponsored health insurance to be excessively prohibitive, especially when an employee or dependent has a significant health problem. Ervin’s bill would create a pilot program to allow insurers to transfer the high risks from the small group to the MHIP through a risk transfer product with the intent to stabilize rates for the small group. It is estimated that half of Missouri’s uninsured population work for small businesses.
Another provision in Ervin’s plan would establish the Insure Missouri program. This program will provide premium assistance to low-income Missourians allowing them to purchase individual health insurance policies. The program is intended to assist at least 71,000 low-income, working adults.
Each Insure Missouri policy holder will be required to make a monthly contribution, based upon income, to a separate account to pay for deductibles and co-pays. Failure to make the monthly contribution will cause the individual to be removed from the program.
“The Insure Missouri plan allows those qualified individuals to purchase an individual health insurance policy while promoting personal responsibility and ownership of their health, leveraging private market innovations, focusing on prevention and wellness, and using existing revenues to pay for the plan eliminating the need to raise taxes,” explained Ervin. “This plan helps eliminate the hidden tax that each of us pay due to uncompensated care from the uninsured and uninsurable populations.”
Ervin recently introduced HB2394 relating to price and quality transparency in health care and HB2413 relating to access and affordability of health coverage through the MHIP and Insure Missouri program.