Missouri has been something of a political marvel over the last century or so, managing to vote for every winning presidential candidate since 1904 with three exceptions, regardless of political affiliation. Despite its status as a bellwether state, Missouri has shifted right in recent elections, transforming from “purple” to red. The Show Me State didn’t take a side in the debate over the constitutionality of the ACA. It did, however, decide not to expand Medicaid according to ACA guidelines.
Enrollment through the Years
Missouri uses the federal marketplace to enroll its residents in healthcare plans. Since 2015, Missouri enrollment numbers have dropped overall. Enrollment peaked in 2016 but declined sharply the following year, which may have been related to the political turmoil surrounding the results of the presidential election.
- 253,430 Missourians enrolled in 2015
- 290,201 Missourians enrolled in 2016
- 244,382 Missourians enrolled in 2017
This year, 75,890 of Missourians enrolled in a marketplace plan for the first time. The remaining 168,492 enrollees were repeat customers. Missouri enrollees tend to be young. The most-represented age group among Missouri exchange customers is the 18-34 bracket.
Missouri chose not to expand Medicaid in accordance with ACA guidelines.
Cost Assistance
The ACA provides cost assistance in the form of premium subsidies to enrollees who earn between 100 and 400 percent of the federal poverty limit. In 2017, 86 percent of people who signed up for marketplace plans qualified for cost assistance in Missouri.
Cost-sharing reductions (CSRs), which are available to people who earn up to 250 percent of the federal poverty limit, are another form of cost assistance provided by the ACA. To qualify, people must sign up for a silver-level health plan. This year, 56 percent of Missouri enrollees were able to get CSRs.
Carrier Participation & Plan Availability
In 2017, there were four health insurance providers offering plans to Missouri residents through the marketplace. This number will drop to three in 2018. The total number of plans offered through the marketplace in Missouri for 2017 was 1,557. Different plans are available to different counties throughout the state, so the actual number of plans that individuals can choose from varies based on where they live.
