Missouri residents shop for ACA health coverage through HealthCare.gov, the federal marketplace, since the state has not created its own exchange.
Missouri expanded Medicaid after voters approved a ballot initiative, so adults earning up to 138% of the federal poverty level generally qualify for MO HealthNet, the state's Medicaid program, instead of needing a subsidized marketplace plan.
Because expansion came through a ballot measure rather than routine legislation, implementation had some early bumps, so residents who believe they qualify but are unsure of their status should follow up directly with the state Medicaid agency rather than assuming automatic enrollment. Marketplace shoppers should compare plan options across Missouri's urban centers, St. Louis and Kansas City, versus more rural counties, since network breadth can vary.