ST. LOUIS, Mo. - Whether Missourians like it or not, the Missouri Health Exchange will open for business on Tuesday, Oct. 1. Lt. Gov. Peter Kinder has been telling them to skip signing up for coverage. However, others wonder why anyone would not shop for a good deal on health insurance.

Health and Human Services Region VII Director Stephene Moore said the costs of premiums nationwide are coming in about 16 percent lower than predicted. She compared shopping on the new health exchange to shopping around for a good price on an airline ticket.

"For some people, it's okay to have a non-stop flight, but for others who want to save some money, they might be willing to go through Denver and have a little layover. It's the same thing with the health insurance. They'll be able to look at the plans and see which one works best for them," Moore said.

According to HHS numbers, a St. Louis family of four making $50,000 a year, because they qualify for a federal subsidy, could purchase the lowest level of coverage for $32 a month. Moore said no matter what you buy, all plans are required to cover the same essential services for children and adults. Those include visits to the doctor, the hospital, emergency care, maternity, mental health, substance abuse treatment, pediatric services, medications and prevention. Missourians will have 17 different plans to choose from. The website for Missourians is www.Healthcare.gov.

"Every plan that's offered in their zip code will pop up, and they'll be able to look at the cost, what the coverage will be and see which one of those plans might work best for them," she said.

Moore pointed out that there is a lot of time to figure it all out.

"Nobody has to rush out on Oct. 1 and get on that website and look at it. They can look at it any time between October the first and through early next spring and the end of March," she noted.

A single person making up to around $45,000 a year qualifies for federal help paying for monthly premiums. So does a family of four making up to $90,000 annually. To get that help, Missourians must sign up through the exchange. Anyone who has coverage through work does not have to do anything.

Information about health insurance marketplace premium costs is available at http://aspe.hhs.gov.




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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.