• The Missouri Department of Insurance received an exchange planning grant of $1 million in September 2010.

• In August 2011 a $20.8 million Level One Establishment grant was received by the Missouri Health Insurance Pool to build a coordinated information technology infrastructure with a single-portal eligibility and enrollement system.

• In April 2012, the state rejected a $50 million federal grant intended to upgrade the Medicaid system because lawmakers felt it would be used for establishing an exchange.

• Since Missouri has not determined a benchmark EHB plan it wil default to the largest small-group plan in the state, Healthy Alliance (Blue Cross Blue Shield)- Blue Access Choice PPO.

• Any intention Democratic Governor Jay Nixon had of establishing an exchange by executive order was twarted by the passage of ballot by the Missouri voters which blocked an exchange. Legislation to establish a state-based insurance network also failed in consecutive legislative sessions. Despite the Governor's support, he announced that Missouri would not pursue a state-based exchange.

• Before reaching that determination, the Missouri Health Insurance Exchange Coordinating Council, representing different government stakeholders, led the state's response to health reform.

For More Information:

• http://www.senate.mo.gov/11info/comm/interim/sihi.htm