Your constituents - both clients and mental health providers - are being treated terribly by UHC and Healthy Blue Medicaid managed care. Please take the time to read this information and respond. I think our clients and your constituents would greatly appreciate an update from me that makes it clear they have your support.

As of March 1, multiple mental health practitioners and group practices will have their participation in UHC and HB Missouri Medicaid networks terminated. The letters they received cited no clinical, quality, or compliance concerns. In addition, UHC is refusing to add providers to their Medicaid roster, even in rural communities. Missouri faces a significant shortage of mental health providers relative to need. As of December 31, 2025, Missouri meets only about 15.18% of the estimated need for mental health practitioners (2025). Missouri also ranks in the lower half of states for mental health provider availability when measured as providers per 100,000 population, reflecting persistent workforce and access challenges.

This decision will force patients to have their mental health treatment disrupted. There are few to no comparable providers in our community to refer them to.  This disruption jeopardizes continuity of care, which is critical for mental health outcomes and often leads to worsening symptoms, emergency department visits, and higher overall costs.

These commercial plans are paid money by the State of Missouri on a per-member per-month capitation basis to ensure access to medically necessary services. Because insurance companies retain state-paid funds for services that are not delivered, this creates a financial incentive to reduce utilization. The actions of UHC and HB are directly in conflict with Missouri’s obligation to ensure access and quality. This is just one example of how commercial health plans disrupt mental health care. Administrative burdens (authorizations, denials and frequent mistakes), exceedingly low reimbursement rates and, refusal to follow signed contracts and interrupting care when network contracts change impact all providers who take insurance. As a result, a vast number of mental health providers don’t take Medicaid or commercial insurance at all, limiting access for Medicaid clients even further.

Given that UHC and HB are paid by the State of Missouri to provide care, the State has both an interest and a responsibility to ensure that these dollars are used to deliver services—not withheld through actions that shrink provider networks and disrupt ongoing treatment. We are requesting that the State of Missouri intervene on behalf of their constituents who need access to mental health care.  

These issues are part of a much larger problem with commercial health insurance overall. Barriers to receiving payment, "ghost" networks, extensive clawbacks years after claims were paid and pitiful reimbursement rates are all reducing the number of mental health providers who are even willing to take insurance. Other states have begun enacting legislation that addresses these problems.

Therefore we are requesting the following:

1. Intervene immediately with United HealthCare and Healthy Blue prevent termination of contracts and loss of services for those struggling with mental issues.  
2. Strengthen enforcement mechanisms to prevent commercial plans from withholding state-paid funds by under-utilizing their provider networks. Require the plans to add providers until the need for mental health services is significantly reduced.
3. Consider legislation similar to Illinois’ proposed SB0055 that introduces provides strong oversight of Medicaid commercial plans, mandates mental health rates to address provider shortages, puts limits on clawback time frames and prohibits the use of AI providing therapeutic decisions for insurance plans.  
   This issue affects your constituents - patients, families, and communities across Missouri. We are hoping that you see the egregious nature of these practices and assist us in stopping them.

Thank you for your time, attention, and commitment to ensuring Missouri’s Medicaid system functions as intended—for the benefit of the residents it serves.