Health Insurance

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.

The Healthcare Protection Act passed the Illinois House last week. Now, it's headed to the Senate. Gov. J.B. Pritzker and state lawmakers say the legislation will put power in the hands of patients and their doctors.

Illinois Gov. J.B. Pritzker celebrated a partial legislative victory late last week when the House passed his initiative to end some practices health insurance companies use to control the amount and cost of health care services individual patients receive.

In Missouri, legislation introduced by State Rep. Melanie Stinnett, R-Springfield, aims to establish a gold carding program for medical treatment and prescriptions.

The state-funded health care programs serving certain low-income noncitizens have declined by tens of millions of dollars in recent months as the state rolled out new copay and coinsurance requirements this week.

Open enrollment to buy health coverage on the federal health insurance marketplace ended on Tuesday. In Missouri, more than 300,000 people have signed up for health plans. The number of people buying plans on healthcare.gov has increased since 2020, with Missouri’s enrollment on track to hit a record high in 2024.