Health Insurance

Democrats in Congress have held off voting on a spending bill unless legislators agree to again approve the tax credits for people who buy insurance on healthcare.gov.

Centene subsidiary Ambetter from Home State Health failed to meet Affordable Care Act requirements for medical care spending. The refunds to Missourians will be more than all insurers paid out nationally rebates in 2023.

The Farm Bureau aims to reach an underinsured population, but without government oversight.

Anthem Blue Cross Blue Shield came under scrutiny for planning to put time limits on anesthesia care in Missouri, Connecticut and New York. The original move, which would have started next year, alarmed doctors and policymakers.

The two companies announced early Wednesday that they had resolved contract disputes that began earlier this year.

Anthem officials claim Mercy is asking the insurer to pay too much money to cover procedures. Mercy officials said Anthem is putting too many administrative barriers in its contract. If the two sides cannot reach an agreement by the end of the year, Anthem patients won't be able to receive in-network rates at Mercy locations.

Missouri has removed roughly 136,000 kids from its Medicaid rolls since June 2023. But the state's worst-in-nation processing delays make it difficult to re-enroll — causing many to miss doctor’s appointments and critical prescriptions.

The Health Care Protection Act bars the use of a restriction known as “step therapy" requiring a patient to try and fail on one or more treatments preferred by the insurance company before they can access a doctor-recommended treatment.

Missouri officials told the federal government the reason for the delays is that several social services programs are competing for limited resources.

Organizers of a protest planned for Friday say the pharmacy benefits manager steers patients to its own pharmacies and drives up prescription prices for consumers.