Keeping Missourians Covered in a Time of Uncertainty


Looking back on Missouri’s extremely successful Affordable Care Act open enrollment period last year (2015-16), I have to say it’s bittersweet. As you can see for yourself in our new infographic, our Cover Missouri Coalition members worked tirelessly to help their fellow citizens understand and sign up for affordable, essential health insurance. 290,201 people gained coverage, an amazing 91 percent increase from the first enrollment period in 2013-14. Since the beginning of the ACA we’ve seen a 25 percent drop in uninsured Missourians under age 65. While more than half a million still need coverage, that reduction is no small feat, and it’s something of which to be proud.

The 2016-17 enrollment numbers are not as positive. Overall signups were down an estimated 16 percent, to 244,382. No one factor singlehandedly led to this disappointing drop, but I would argue that one had the largest impact by far: uncertainty.

The new presidential administration made it clear before and after the election that they hoped to dismantle the ACA. A day-one executive order led some to believe that the dismantling had already begun. Our Cover Missouri Coalition worked to spread the message that the ACA remained the law of the land, but they were fighting an uphill battle.

We remain proud of our efforts because nearly a quarter of a million Missourians enrolled in Marketplace coverage. But as we take a detailed look at all of our work from last year’s enrollment period, it’s hard not to think about how many more people we could have gotten covered this year if the circumstances were different.

We as a nation are healthier and better off economically when everyone has high-quality, affordable health coverage.  Unfortunately, as long as this period of uncertainly continues, people will face confusion and challenges to remaining insured. As our CEO recently wrote, it is incredibly important that we keep ourselves informed about the future of the ACA and MO Medicaid, so that we can ensure that whatever health care changes take place, we are prepared to not leave anyone behind.

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Nancy Kelley is the program director for MFH’s Expanding Coverage initiative.