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In 2003, Missouri received HRSA State Planning Grant funds to research the uninsured and the health care marketplace in Missouri. A Council on the Accessibility and Affordability of Health Insurance Coverage was convened to review both existing and newly collected data on the uninsured and develop a multi-year plan to address the uninsured.

In 2005, Missouri was awarded a HRSA pilot grant. Using the data collection activities and consensus building strategies from the State Planning Grant, the team modeled several employer-based coverage options.