The Missouri Senate has passed a bill allowing the Missouri Farm Bureau to sell health benefit plans that bypass federal consumer protection rules.
These plans can exclude coverage for pre-existing conditions and offer fewer benefits than those required under the Affordable Care Act (ACA). The bill passed by a vote of 24–6.
Republican Sen. Kurtis Gregory, who sponsored the bill, said the Farm Bureau does not seek government funding and wants to self-fund the program to support members.
The nonprofit Farm Bureau partners with for-profit insurers and charges a $30 annual membership fee. While historically composed of rural residents, anyone can join.
The bill reclassifies these offerings as “health benefit plans” instead of “insurance” to avoid state and federal regulation.
It’s the third attempt in Missouri to pass this type of legislation. Ten other states have similar laws.
Democrats and patient advocates opposed the bill. They argue the plans provide inadequate protection and lack uniform standards. Democratic Sen. Tracy McCreery stressed the need for consistent safeguards across providers.
As part of negotiations, Democrats secured several amendments. The plan contracts must include a disclaimer clarifying they are not insurance, don’t meet federal standards, may exclude pre-existing conditions, and that the applicant might qualify for federal subsidies.
The Missouri Department of Commerce and Insurance must now also accept and review complaints related to the plans.
Additional amendments added Medicaid coverage for hearing aids, broader access to STI treatment, and a requirement for insurers to offer extended supplies of birth control. These changes helped Democrats allow the bill to proceed.
The bill now moves to the Missouri House, which has passed similar versions in the past. Gregory estimates around 15,000 Farm Bureau members lack coverage and could benefit from the plan.
Supporters, including Republican Sen. Sandy Crawford, argue many farmers earn too much to qualify for subsidies but can’t afford ACA plans. Crawford said high costs have prevented her constituents from getting coverage.
Farm Bureau lobbyist Emily LeRoy described the bill as an added coverage option. The plan would use medical underwriting, a pre-ACA method of assessing applicants based on health history, to control costs and set prices.
Tennessee implemented a similar law in 1993. According to Benjamin Sanders, representing the Tennessee Farm Bureau, those plans report high satisfaction and retention, though they are not required to meet data transparency rules.
Emily Kalmer, speaking for the American Cancer Society Cancer Action Network, warned the bill enables plans that discriminate against people with conditions like cancer.
