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Missouri health advocates target rural, minority areas as enrollment opens on insurance site


JEFFERSON CITY, Missouri — Advocates for expanded health insurance coverage are trying to sign up more minorities and rural Missouri residents during an annual enrollment period that begins Saturday for a federally run insurance marketplace.

About 150,000 Missouri residents already are covered by insurance policies available through, the website established under the federal health care law. If they do nothing, those people automatically are re-enrolled for 2015, but they also can choose to change policies.

Anyone lacking affordable insurance can purchase coverage through the website. Enrollment runs through Feb. 15, but to be covered when the new year begins, people must sign up by Dec. 15. Many people are eligible for federal subsidies that reduce their out-of-pocket costs.

Health care organizations are spending several million dollars in Missouri to promote the insurance website and guide people through the sign-up process. Grant funding has been increased this year to groups serving urban minority populations and rural areas such as the Bootheel, where enrollment has trailed other places.

In Sikeston, the Missouri Bootheel Regional Consortium plans to give away hotdogs, popcorn, cookies and soft drinks Saturday as part of its promotional kickoff for the health insurance enrollment period. The group also plans to offer blood pressure checks and free flu shots to the uninsured.

Enrollment events also are planned elsewhere.

The International Institute in St. Louis plans to have interpreters available Saturday for immigrants and foreign refugees seeking health insurance. Last year, the institute's certified enrollment counselor helped 187 people sign up, many of whom were Bosnian or Vietnamese immigrants. This year, the institute got a grant from the nonprofit Missouri Foundation for Health to hire a second counselor and has set a goal of enrolling 500 people over the next two years.

The foundation distributed $4.5 million this year for regional organizations to promote the federal insurance site and help people enroll. The federal government distributed an additional $1.6 million to Missouri organizations to hire "navigators" for consumers.

The 2010 health care law enacted by President Barack Obama requires online insurance sites in each state, operated either by that state or the federal government. Federal officials are running the Missouri site, because state voters approved a law prohibiting Missouri officials from taking any steps to establish an insurance exchange.

In many parts of Missouri, consumers will have more insurance plans to choose from than previously, but monthly premiums also may rise. The choices and prices vary by county. Residents in St. Louis County will be able to choose from among more than 40 plans offered by four insurers for 2015 — about twice as many as this year.

But residents in some south-central Missouri counties such as Howell and Phelps will have 17 choices offered by two insurers, about the same selection as for 2014. In some rural northern Missouri counties, such as Livingston and Mercer, residents will have 14 insurance options for 2015 offered by two companies, up slightly from 11 choices.

"We're excited for consumers in Missouri to have more choices," said Ryan Barker, vice president of health policy at the Missouri Foundation for Health. "At the same time, it's a challenge — the more choices you have, the more confusing it can be."

Rural areas generally appear to have fewer choices and higher prices than more populated areas, according to estimates available on the federal website. That's frustrating for some health care advocates.

"For years we've had poorer access to health care in rural communities," said Jen Bersdale, executive director of Missouri Health Care for All, a St. Louis-based coalition that supports the federal health care law. "It's disappointing, to say the least, that that may be the case here too," with the online insurance marketplace.

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