Missouri lawmakers in Washington differ on how to deal with an insurance company’s exit from Affordable Care Act exchanges.

Blue Cross Blue Shield of Kansas City announced Wednesday that it would pull out of the individual exchanges by the end of the year.  According to the Kaiser Family Foundation, the move could leave as many as 25 western Missouri counties with no coverage.

Congresswoman Vicky Hartzler (R-MO 4th District)

4th District Republican Congresswoman Vicky Hartzler represents a large chuck of those counties.  She contends the pull-out is the direct result of the Affordable Care Act’s mandate which, according to her, makes it difficult for insurers to provide affordable plans.

She says “Obamacare broke the healthcare system and state by state, the system is collapsing”.  She’s urging the Senate to pass the Republican backed American Health Care Act, which narrowly passed the House 117-113 earlier this month.  All 193 Democrats voted against the bill, along with 20 Republicans.

The 5th District represented by Democrat Enanuel Cleaver also includes a large swath of the counties impacted by the Blue Cross Blue Shield exit.  He thinks the insurance giant’s move should be a wake-up call for Congress.

Congressman Emanuel Cleaver (D-MO 5th District)

“Trumpcare is not the answer” said Cleaver.  “Congress must come together to improve the ACA, not start again from zero with a plan that would harm so many Americans.”

A non-partisan government report released Wednesday said the Republican plan would provide a $119 billion deficit reduction, but would also lead to 23 million fewer people having healthcare over the next 10 years.

Perhaps anticipating the Blue Cross Blue Shield exit, Missouri’s Democratic U.S. Senator Claire McCaskill introduced legislation a week ago to prevent counties from having no insurers on their health care exchanges.

Under her plan, people without an option would be able to buy healthcare insurance from the exchange in Washington D.C.  That market has national plans which provide work based coverage for the staff of every congress member.

The difference is, instead of getting an employer contribution, people on the exchange would be getting the same subsidies currently offered in exchanges in their state.  McCaskill’s measure would instruct the Treasury Department and the Department of Health and Human Services to set up a mechanism to give people in the states access to the national plans.

Short of the McCaskill offering being adopted, the Missouri exchange has few options.  One scenario would be for the state to suspend the penalty for not having insurance and allow people to go uninsured.

Such a move could be plausible in Missouri, which is governed by Republicans who are largely hostile toward Obamacare in general.