A proposal that proponents say would improve the health care provided to low-income and vulnerable residents via the Missouri Department of Social Services was outlined Tuesday in Joplin.

Mo HealthNet Director Dr. Ian McCaslin will conduct four hearings, including one Nov. 10 in Springfield, to start the conversation about whether Mo HealthNet "Managed Care" should come to some 21 southern counties.

Health care providers and mental health workers packed a hearing Monday in Springfield to testify how bad they think Mo HealthNet managed care would be for southwest Missouri families.

Health care played a big role in the presidential campaign. But the administration will face a tough choice: try for a wide-ranging systematic overhaul -- an approach that failed when President Bill Clinton tried it in 1993 -- or make do with piecemeal fixes.

Striking new evidence has emerged of a widespread gap in the cost of health insurance, as women pay much more than men of the same age for individual insurance policies providing identical coverage, according to new data from insurance companies and online brokers.

Economic troubles are forcing states to scale back safety-net health-coverage programs -- even as they brace for more residents who will need help paying for care.

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www.CoverMissouri.org

More than 700,000 Missourians currently have no health coverage. The cost of health coverage presents a considerable barrier to many of the uninsured. As the state wrestles with policy options to reduce the number of uninsured, it is critical to understand what Missouri residents can afford for health coverage.

Research in other states suggests that incorporating a definition of affordability into health policy significantly affects the viability of the proposed programs. Community Catalyst, a national nonprofit organization focused on health reform, has created a methodology for defining health insurance affordability and developed a model for calculating health care affordability for Missouri. This model considers affordability standards of non-health public programs, the cost of basic needs (e.g., housing, food, and transportation) for Missouri families, current spending on health care, and price sensitivity to health insurance.

The report concludes that the following should be considered when designing health coverage policies for Missouri:

• Any affordability schedule should utilize a progressive scale as incomes increase. A progressive sliding scale will prevent people with lower incomes from paying a disproportionately higher share of their income for health insurance.
• People with very low incomes can pay only small amounts toward health care. Studies of household budgets in Missouri indicate individuals below 150 percent of the federal poverty level (FPL) or $15,600 a year, and families below 200 percent of FPL (e.g., $35,200 for a family of three) may not earn enough to cover their basic needs.
• The upper bound of affordability should be set at about 8.5 percent of income. Data suggests that people with higher incomes can reasonably afford health insurance at 8.5 percent of income. In Missouri, “higher income” indicates an annual income above 500 percent of the FPL, or $52,000 for an individual.
• A progressive sliding scale of affordability is needed. For those earning enough to make some contribution to their health care, a sliding scale is recommended as protection from financial hardship. In Missouri, this scale should progress from 1.8 percent to 8.5 percent of income for individuals earning between 150 to 500 percent FPL ($15,600 and $52,000).