Like in 2013, President Barack Obama’s health care overhaul was a target of conservative lawmakers in Missouri again in 2014, the first year of health insurance coverage provided under the Affordable Care Act’s individual mandate.
With strong majorities in both chambers of the Missouri Legislature, Republicans relentlessly fought the implementation of the Affordable Care Act, and they appear likely to continue blocking the law next year. Missouri lawmakers did not authorize a state-run online marketplace and have struck down Medicaid expansion.
Read more: Check out the rest of Missouri Business Alert’s Stories of the Year for 2014.
While the number of uninsured Americans in 2014 dropped by about 25 percent, according to an analysis by the New York Times, the Show-Me state has seen little change in its uninsured rate, which dipped to 15.1 percent this year from 15.2 percent in 2013.
An unlikely coalition formed in support of expanding Medicaid in the state. The Missouri Chamber of Commerce and Industry enlisted former U.S. Sen. Kit Bond, a Republican, to lobby for expansion. State Sen. Ryan Silvey, a Kansas City Republican, emerged as a leading proponent of modifying and expanding Medicaid, and he clashed with other Senate Republicans in his pursuit of that goal. The state’s military veteran organizations also joined Bond and Silvey in advocating for expanding Medicaid.
But the Republican-controlled General Assembly defeated all attempts to expand medical care for some 300,000 low-income Missourians. Despite the estimated $1.7 billion Missouri would have received from the federal government for expansion in 2015, opponents argued that Medicaid bills would be too costly for the state and would divert funding from education.
Online registration for the state’s Small Business Health Options Program (SHOP) opened for the first time in November. The program was designed to let workers at companies with 50 or fewer employees choose health plans from designated tiers. But options were limited, as only one insurer, Anthem BlueCross BlueShield, offered plans on the Missouri marketplace for 2015.
Any progress on Medicaid expansion next year will have to get through the GOP-controlled legislature, and it seems unlikely the law will come up for a vote. With Republicans also seizing control of Congress during November’s midterm election, it remains to be seen what the political power shift in Washington means for the Affordable Care Act, which some Republicans have repeatedly promised to repeal.