A new report on the health insurance markets in Missouri was released today by the Missouri Department of Commerce and Insurance (DCI).  As in past years, 2018 had a very limited number of health insurance companies selling in the State. The largest four insurers in the small and large group markets have a market share in excess of 90%, and over 95% in the individual market, according to 2018 data. Since not all insurers write everywhere in the state, some Missouri regions have only one insurance company offering health insurance products in the individual market, which limits consumer choice. 

The report, which focuses primarily on major medical coverage, makes use of diverse data sources to provide an overview of Missouri’s health insurance market. In addition to data possessed by the DCI, additional sources include the Current Population Survey (CPS), the American Community Survey (ACS), National Health Expenditure Data from the Bureau of the Census, and other key indicators available from the US government. 

Some additional highlights from the report include:

• There is mixed data regarding the uninsured in Missouri. In 2018, those who lacked health coverage for the entire year declined to a record low of 6%. However, those who lacked health insurance coverage for part of the year increased from 9.1% to 9.4%.
• Nearly all insureds in the individual market obtained coverage in the federal exchange, which for many counties offers limited choice. 78 of Missouri’s 115 counties had only a single insurer participating in the exchange. An additional 24 counties had only 2 insurers.
• Insurance rates per person, per year, declined slightly in the individual market for 2020, decreasing from $7,651 to $7,582, a decline of almost 1% (-0.9%). However, costs in the small employer market are expected to increase by 5.8%, to $6,995 per person, per year.
• Rebates to Missourians for 2018 are the second highest since these payments began. For 2018, rebates under the MLR standard of the ACA will total $52 million, with an almost even split between the individual and small group markets. 
• The majority of individuals with private coverage continue to receive it through employer-sponsored plans (the majority of which are self-insured). Only a little over 6% of Missourians were insured through the private individual market. The remaining Missourians have coverage from various public programs such as Medicare (19.4%), Medicaid (15.2%), or other programs such as the VA (5.4%).

The Missouri Health Insurance Innovation Task Force, appointed by Governor Mike Parson in July of this year, is currently working to identify ways to curb rising healthcare premiums and increase access and competition in health insurance markets for all Missourians. The group began meeting in August and is on track to deliver recommendations to the governor in January, 2020.