Missouri currently faces considerable challenges related to creating an equitable and comprehensive system of health care for all Missourians. In 2006, more than 700,000 Missouri residents were without health insurance.Research broadly documents the serious health and financial consequences associated with being uninsured. The uninsured live sicker and die younger than those with insurance. They forego preventive care and seek health care at more advanced stages of disease. Society then bears these costs through lower productivity, increased rates of communicable diseases, and higher insurance premiums.

In an effort to inform the discussion regarding practical policy options to expand health care coverage for the uninsured in Missouri, MFH has established the Cover Missouri Project. Under this project, MFH has engaged The Urban Institute to produce a series of papers which considers strengths and weaknesses of the current health care system in Missouri and explores options for decreasing the number of uninsured. MFH offers these studies as a means to further understand and ultimately improve access to health care coverage.

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Cover Missouri Project: Data Book

Data Book 2: The Cost of Care for Missouri's Uninsured
Summary: This data book examines the cost of the uninsured borne by the state and its residents.

Prepared by:
Stephen Zuckerman, PhD, Principal Research Associate
Randall R. Bovbjerg, JD, Principal Research Associate
Jack Hadley, PhD
Matthew Cravens
Lisa Clemans-Cope, PhD, Health Economist

View the: Fact Sheet | Report

Data Book 1: Health Insurance Coverage in Missouri, 2003 - 2004
Summary: This chart book profiles sources of health insurance coverage in Missouri.

Prepared by: Allison Cook, BA, The Urban Institute
View the Report

Cover Missouri Reports:

Report 1: Consequences of the Lack of Health Insurance on Health and Earnings
Summary: This paper represents the first in the series emerging under the Cover Missouri Project. It examines the serious health and financial consequences associated with being uninsured, as well as the importance of health insurance as it relates to people's access to care, use of services and ultimately to their health outcomes.

Prepared by: Jack Hadley, PhD, The Urban Institute
View the: Fact Sheet | Report

Report 2: Costs, Access, and Utilization Under Medicaid: A Review of the Evidence
Summary: This report reviews data and linkages among cost, access and utilization of Medicaid.

Prepared by:
John Holahan, PhD, Director, The Urban Institute
Sharon K. Long, PhD, Principal Research Associate, The Urban Institute
View the: Fact Sheet | Report

Report 3: The Missouri Economy and Changes in Health Insurance Coverage, 2000 - 2004
Summary: This paper provides a broad overview of how individual states are confronting the nationwide challenge of constraining health care costs. It offers a timely and much-needed view to a range of policies, as well as their potentials and their costs.

Prepared by:
John Holahan, PhD, Director, The Urban Institute
Allison Cook, BA, Research Assistant, The Urban Institute
View the: Fact Sheet | Report

Report 4: Missouri Medicaid Spending Growth: 2001 - 2005
Summary: This paper profiles cost changes in Missouri's Medicaid program over five years.

Prepared by:
John Holahan, PhD, Director, The Urban Institute
Mindy Cohen, MPH, Research Associate, The Urban Institute
View the: Fact Sheet | Report

Report 5: The Quiet Medicaid Revolution: State Waiver Activity in the Early 2000s
Summary: This paper is a broad view of waiver activities, including those that deal with special populations.

Prepared by:
John Holahan, PhD, Director, The Urban Institute
Teresa A. Coughlin, The Urban Institute
View the: Fact Sheet | Report

Report 6: The Missouri Health Insurance Pool: Issues for Policymakers

Summary: This piece provides background and specifically examines Missouri's high-risk pool, comparing it to those in other states. It offers specific recommendations for consideration regarding enrollment, benefits, costs, and funding issues.

Prepared by: Karen Pollitz, MPP, Georgetown University Health Policy Institute
View the: Fact Sheet | Report

Report 7: Expanding Coverage Through the Missouri Consolidated Health Care Plan (MCHCP)
Summary: This report examines ways that Missouri could use its state employees' health plan to expand insurance coverage to small businesses. The purpose of this study is to discuss key design decisions and explore the advantages/ disadvantages of allowing small employers to buy coverage through MCHCP.

Prepared by: Elliot Wicks, PhD, Economist and Policy Analyst, Health Management Associates (HMA)
View the: Fact Sheet | Report

Report 8: Geographic Variations in Health Insurance: A Profile of Missouri
Summary: This study examines trends in insurance coverage by geographic area and by subgroups such as age, ethnicity, income, and firm size. It also analyzes differences in the types of insurance that people have in large cities compared to rural communities and small cities throughout Missouri.

Prepared by: Stephen Zuckerman, PhD, Principal Research Associate
Allison Cook, BA, Research Assistant, The Urban Institute
View the: Fact Sheet | Report

Report 9: Increasing Health Insurance Coverage in Missouri Through Subsidies
Summary: This study compares the benefits of subsidizing employers vs. subsidizing individuals to increase health care coverage for the state.

Prepared by: John Holahan, PhD, Director, The Urban Institute
View the: Fact Sheet | Report

Report 10: High-Deductible Health Plans with Health Savings Accounts: Emerging Evidence and Outstanding Issues
Summary: This study lays out both advantages and disadvantages of the use of high deductible plans. It touches on why this solution may exacerbate risk selection issues that already seem to be present in Missouri. It discusses how these plans can be a somewhat better deal for a large swath of the population that is younger and healthier but only at some cost.

Prepared by:
Lisa Clemans-Cope, PhD, Health Economist, The Urban Institute
Fredric Blavin, BA, Research Associate, The Urban Institute
Genevieve M. Kenney, PhD, Principal Research Associate and Health Economist, The Urban Institute

View the: Fact Sheet | Report

Report 11: Implementing Reinsurance: Health Insurance Reform in Missouri
Summary: This piece describes how public reinsurance could be structured in the state to spread risk and lower premiums. It provides the evidence on how such an approach could reduce costs of private insurance plans.

Prepared by: Randall R. Bovbjerg, JD, Principal Research Associate, The Urban Institute
View the: Fact Sheet | Report