With the federal Health Insurance Marketplace now up and running, Missourians have the opportunity to become part of the growing population of Americans who have affordable, quality health care coverage within their reach. This marketplace, made available by the Affordable Care Act (ACA), allows Missourians to compare health care options using side-by-side information regarding price, quality and benefits for each health plan under consideration.

Signing up is as easy as visiting www.healthcare.gov. Users will then create an account, fill out the application, compare plans and get coverage. The website is shutdown for repairs from 1-5 a.m. daily, until the repairs have been completed.

Enroll by Dec. 15 to be covered by Jan. 1, 2014.

Enroll by March 31, to avoid penalty.

Penalty for not having insurance is $95 a year or 1 percent of household income. There will be a new box on your W-2 tax form to verify health insurance.

Fill out an application at www.healthcare.gov to see if you qualify for a discount or tax credit.

There are several ways to learn more about the ACA or the federal Health Insurance Marketplace:

• Visit www.healthcare.gov for live chat assistance.
• Call the Marketplace Call Center: 1-800-318-2596, it is open 24/7.
• Visit www.covermissouri.org.
• Call 211 for local social services assistance to find a federally qualified health center that will provide in-person assistance to fill out forms and find a certified navigator.
• Download a paper application that can be printed and mailed. (If choosing this option, please utilize the guidance of live chat or phone or local navigator to ensure accuracy).

There are no fees to use the marketplace and no one should solicit health coverage to you. Report fraud to the Missouri Attorney General’s office, by calling 1-800-392-8222.

Here is a checklist of information you will need when you sign up:

• Social Security Numbers (or document numbers for legal immigrants)
• Employer and income information for every member of your household who needs coverage (for example, from pay stubs or W-2 forms—Wage and Tax Statements)
• Policy numbers for any current health insurance plans covering members of your household
• Completed Employer Coverage Tool for every job-based plan you or someone in your household is eligible. (You’ll need to fill out this form even for coverage you’re eligible for but don’t enroll in.)  Visit www.healthcare.gov to view this form.

For  information on health care seminars in the St. Louis area go to: http://covermissouri.org/tools/events/events.php

For more information on Medicare, please visit www.missouriclaim.org or call 1-800-390-3330.

Missourians who are eligible for Medicare are urged to review their plan options and costs during this year's open enrollment, which began on Oct. 15 and will run until Dec. 7. During the open enrollment period, consumers can change their Part D drug coverage or Medicare Advantage plans. Medicare is not part of the federal health insurance marketplace under the Affordable Care Act, and the marketplace (mentioned in the previous article) is not meant to serve Missourians with their Medicare needs.

The Missouri Department of Insurance will help citizens choose a plan that best meets their needs through the CLAIM program, which provides free, unbiased help to Missourians (and their caregivers) who are on Medicare, the elderly and people with disabilities.

By utilizing the assistance of a CLAIM counselor, Missourians can get better health care and drug coverage or save money by signing up for a different plan. Counselors might also help citizens who are living on a limited income by notifying them whether or not they qualify for federal or state assistance to pay for prescription drugs. In addition, the Extra Help program through Medicare and the MoRx program through Missouri can also prove to be valuable resources for Missourians.

For more information visit www.missouriclaim.org or call 1-800-390-3330.

Seventy-five percent of Missouri's uninsured adults were members of the labor force in 2011.

• Missouri currently ranks 42nd nationally regarding its health status, compared to its ranking of 24th two decades ago, according to America's Health Rankings. The MHA report finds that without improvements in the overall health of Missouri's population, businesses and our state's health system will not realize the gains of lower health care costs, better health care quality and increased worker productivity.
• Poor health contributes to the loss of worker productivity. Between 2007-2009, Missouri's gross domestic product for blue collar and service industries fell by $8.5 billion - an 18 percent decrease - while the uninsured rate among these employees fell by 10 percent.
• In 2013, a parent in a three-person family could not bring home more than $3,500 to qualify for Medicaid, which precludes almost all working adults from Medicaid eligibility in Missouri. For example, a single-working parent of two cannot earn more than $9.59 a day to qualify for Medicaid in Missouri. Because of these strict eligibility standards, a large number of our state's uninsured citizens are low-income working adults in blue collar and service industries.
• On average, an uninsured Missourian was treated in one of our state's hospital emergency rooms every minute of every day during 2012.

Senator Keaveny speaks with constituents at an early October district meeting at the Mid-County YMCA in Brentwood.

• As society learns more and more about how we can better treat metal illness and how crucial it is that we are aware of those suffering from problems related to these diseases, why is Missouri cutting its amount of staffed beds at mental health facilities? Where is the state on this issue?
• The state needs to look at the school transfer issue in the eyes of the students. One family shared with those attending the meeting that their son sits in his class next to a recent transfer student and these two children have become friends who help each other with their school work. This family has even invited this student over for dinner, extending a friendship beyond the classroom.
• Other constituents express the need for Medicaid expansion, saying they are paying for the expansion already (without reaping the benefits) in a variety of other ways, citing emergency room visits for illnesses that could be treated by primary care physicians and severe issues that could have been prevented.

While we all may hold to our personal beliefs in how to solve these issues, what's important is that we are coming together to openly discuss these concerns. Neighbors need to keep talking to neighbors, elected officials should continue explaining the challenges and shortcomings to their constituents, and ultimately, disagreements can be met by choosing the middle ground. If we continue to stay engaged with these issues we all face, then there should be no doubt that we can overcome them.

So next time you see a flier or a yard sign advertising an upcoming neighborhood meeting, please talk with your friends and families and attend these events. These meetings provide a great way to talk to your neighbors and meet with your elected officials to voice your concern, find out ways to volunteer in your community, and receive the answers to your important questions. This is how we continue to build a strong district that can meet the challenges it faces.