by Lauren Brucker
SLU LAW’s Grassroots Health Law and Policy students were part of the team that worked to pass two recent pieces of Missouri legislation that are expected to be signed Gov. Jay Nixon this month.
SB 865 ensures Missouri is no longer the only state without an effective insurance rate reviews. As St. Louis Public Radio reported,
“The law…gives the Missouri Department of Insurance, Financial Institutions and Professional Registration a chance to determine if a rate hike is unreasonable ahead of time, notify the insurer and request a change. If the insurer moves forward with a rate that has been deemed unreasonable, the agency can make the determination public. But it cannot reject those increases.
The rates affect about 350,000 Missourians who are eligible to purchase an individual health plan on Healthcare.gov each year. Because the state legislature has repeatedly voted not to expand Medicaid coverage, about 109,000 Missourians are not eligible for federal subsidies to make insurance plans more affordable on the exchanges.”
Additionally, people with disabilities and older Missourians on Medicaid will be able to save more of their own money without sacrificing needed health coverage with the passage of HB 1565. A broad coalition of organizations, including advocates from the disability community, mental health and social service providers, advocates for seniors, and health advocates worked to help raise Missouri's asset limits for the first time in 50 years.
Grace Flash, a J.D./ M.P.H-Health Management & Policy dual degree student, and Dorothy Rodriguez played a role in advocating for the changes through the Grassroots Health Advocacy course, taught by Jane and Bruce Robert Professor of Law Sidney Watson.
Flash, who also serves as lead editor for the Saint Louis University Journal of Health Law & Policy, is grateful for the opportunity to see and play a role throughout the entire process. “We were definitely fortunate to see the bill develop from a very infancy – where it was multiple bills, to the committee hearings, modifications, to the final draft that was eventually passed,” she said. “Having a hand throughout the whole process was very exciting as well as rewarding.”
The two share their thoughts on the experience advocating for their fellow citizens.
How were you involved in the advocacy for this legislation?
Flash: I was involved with the researching other state rate review laws, federal laws, market place plans and changes in premiums over the years, formulating bill language, lots of editing. We also drafted testimony to be heard by the insurance committee in Jefferson City, fact sheet to accompany the bill, and most importantly serving as a policy expert during our lobby days.
Rodriguez: I wrote a letter to the editor that was published in the newspaper in the Joplin/Springfield, MO area. Additionally, I went to two lobby days with MO HealthCare for All where we lobbied various representatives and senators to help them understand what the bill said and why it was important. I also shadowed a lobbyist for a day and was able to advocate for the bill that day as well. Finally, Grace and I helped with a number of items, including assisting with language for the bill, research to answer questions for key legislators, and creating a fact sheet for use by others at MO Healthcare for All as they lobbied. The fact sheet was also left for legislators for informational purposes. Prior to the first lobby day we also created "talking points" for MO HealthCare for All.
What kind of work did you find most challenging?
Flash: I believe one of the most challenging aspects would have to be simply starting a first draft of the bill. Since Missouri was the only state in the nation without rate review for their health insurance premiums, finding an appropriate starting point that would satisfy the different stakeholders was a somewhat challenging start. Essentially we were doing a significant amount of research, and now I would say my partner and I are experts on the subject. However, as we continue to edit, research, and then receive drafts from legislators on both sides of the political aisle it became a bit easier to navigator as well as advocate for certain provisions to be added or remain in the bill.
Rodriguez: The most challenging was the multiple re-writes of the bill language to appease the health insurance lobby. I felt like it was “watering down” the bill, but was also happy that we were able to get something moved forward – baby steps to get where we want to be.
What surprised you the most about this process?
Flash: This was my first time going to Jefferson City and being a part of the lobbying and the committee hearing testimony, so it was a very different experience as a whole. However, I believe what surprised me the most about this entire process was how effective our initial lobby day was in bringing awareness and interest in supporting our bill. Literally minutes after our first lobby day there were a handful of legislator who had cosponsored the rate review bills.
Rodriguez: I knew that lobbyists were influential, but did not realize that most legislators will not vote for a bill unless certain lobbyists say it is ok. It seemed like the representatives are controlled more by lobbyists than I had even imagined.
How has this experience prepared you for your future career?
Flash: In the future I hope to be able to develop public policy as well as regulations in relation to health care. The Grassroots Advocacy course has provided me with a very unique experience where I was a part of the advocacy from a grassroots level got a bill to be passed into law while interacting with the various stakeholders along the way. I know the skills I’ve acquired this past year will help me in my future career.
Rodriguez: Understanding how a bill moves through and gets passed, including all the politics and lobbying that is involved, really helped me see why laws are the way they are. No matter what industry you are in, an understanding of this process is essential because laws and regulations affect all businesses. Since I will likely be in corporate law, this is essential understanding needed to know how to influence the legislator for laws favorable to my employer, the entity I will be advocating for.