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Bill

HB 3255

Establishes the "Missouri Universal Health Assurance Program" to provide a publicly financed, statewide insurance program for all residents of the state

2026 Regular Session Introduced by Marlene Terry

Missouri bill creates statewide publicly-funded health insurance program covering all residents, fundamentally restructuring state healthcare financing and coverage systems.

Referred: Emerging Issues(H)
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Bill Summary · HB 3255

Legislative bill overview

HB 3255 proposes creating the "Missouri Universal Health Assurance Program," a state-funded health insurance system designed to provide coverage to all Missouri residents. The bill would establish a publicly financed alternative to the current multi-payer insurance system, funded through state appropriations rather than individual premiums or employer contributions.

Why is this important

This represents a significant restructuring of how healthcare is financed and administered in Missouri. Implementation would affect insurance markets, healthcare provider relationships, tax structures, and access to medical services for all state residents—making it one of the most consequential healthcare policy changes ever proposed in the state.

Potential points of contention

  • Financing mechanisms: Unclear how the program would be funded (income taxes, sales taxes, payroll taxes, or general revenue) and whether existing taxes would increase substantially to cover estimated costs
  • Provider participation and payment rates: Hospitals, doctors, and healthcare systems may resist if reimbursement rates are lower than current insurance payments, potentially affecting service availability
  • Federal law conflicts: Missouri would likely face legal challenges regarding Medicaid structure, insurance regulation authority, and whether the program complies with federal healthcare requirements
  • Implementation timeline and transition: Moving millions of residents from private insurance to a public system creates complex logistical, administrative, and employment challenges
  • Political ideology: Fundamental disagreement exists about the government's appropriate role in healthcare versus market-based approaches

Compiled from official sources — confirm details with the bill’s official record.

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