Rising premiums vex the minority paying full price for health insurance

Michelle Harris, 61, had waited since July to hear the price of her 2017 health insurance plan. In her Columbia Falls home this week, she spread the results across her kitchen table. 

Her Blue Cross Blue Shield bronze plan jumped from $1,150 a month to $2,060 in 2017 with a $13,000 deductible.

“That’s over 30 percent of our income,” Harris said. “The more I dig into it, the crazier I feel. We’re looking at having to spend almost $20,000 before insurance begins to help. I just never believed our government would say you have to spend all this money for substandard insurance.”

Harris is one of the 35,000 Montanans on individual market insurance who stand in the shadow of towering price increases without a tax break.

The fourth year for enrollment in the Affordable Care Act kicked off this week. Shoppers have until Dec. 15 to pick a plan before they’re automatically re-enrolled in their current one, which may come with a new price tag.

Until last year, Harris paid just over $300 a month for insurance. But that changed when she got married last September. The couple’s dual income pushed them over the $64,080 limit to receive a cost-reducing federal subsidy.

“People said we were crazy, including our accountant,” Harris said. “But you find someone in your late 50s. You fall in love and this man loves you enough to say, ‘Will you marry me?’ How sweet is that? It was months later that we understood what they meant.”

Before realizing the increases were coming, Harris joined her husband’s insurance plan to retire after working in restaurants for 46 years.

The couple’s cheapest option for 2017 is a bronze plan with Montana Health Co-Op for $1,400 a month and a $13,000 deductible.

“We don’t know how we’ll balance the cost. We actually thought, ‘Should we get a divorce?’ But I’d lose my retirement,” she said. “I could see if I could find a job that would hire a 61-year-old woman and offer health benefits, or go back to work part-time. I could get an attitude and say, ‘My God, I’ve worked since I was 15 — I worked so hard, and I think that this whole system is so wrong.”

WHILE THE number of insured Americans grew under the Affordable Care Act, that percentage is disproportionately filled with consumers with immediate and expensive medical needs. The Obama Administration expected after the act’s implementation that healthy consumers would enter the market and balance the cost. But enrollment fell short.

In October, the administration announced the average cost of health insurance will increase by 22 percent in 2017 as insurers balance their rates to match the new shape of the market.

In Montana, increases among the state’s three health insurers surpass the national average. Blue Cross Blue Shield of Montana had an average rate increase of 58 percent. Montana Health Co-op went up by more than 30 percent and Pacific Source almost increased by 28 percent.

The Department of Health and Human Services has worked to convince the millions of people who get their health insurance through the Affordable Care Act exchanges or who don’t have coverage to shop for a good deal at healthcare.gov — and most consumers will be able get one.

According to Health and Human Services, 85 percent of consumers will receive tax breaks based on their income. In Montana, about 83 percent of shoppers will see those subsidies.

The minority of Americans without a break comes to 10 million people, according to the Congressional Budget Office.

Christina Geo, a general counsel with the commissioner’s office, said the small slice of Montanans most impacted by the increases will be people who retire before 65 — people who live on a fixed income and face higher rates of insurance based on their age, but don’t yet qualify for retiree insurance.

Rick Dodds of Whitefish is one of those early retirees. After successfully owning his own business and ending his career this year, Dodds retired at 58.

He knew his income disqualified his family for any subsidies. But he didn’t expect his PacificSource bronze plan to increase by 45 percent.

“It’s going to cost $1,701 a month. In 2017, we’ll pay $20,412 in premiums and have a $13,100 deductible. That’s a lot,” Dodds said. “Our peer group is that age group of people who are thinking about retiring and people who have been reasonably successful. It’s not like poor me. We can afford to do it — this year — it’s just kind of shocking.”

Dodds’ insurance covers himself, his wife and their 20-year-old daughter who is a Columbia University student currently studying abroad in Oxford.

“We’re kind of stuck in this,” he said. “People plan their lives so that they’re able to retire at a certain age, and you may have made decisions that cannot be changed at that point … then this happens, and you think, ‘Am I going to be able to do this if it keeps going up?’”

THE FEE for not having health insurance in 2016 was $695. Joe Biby of Kalispell said that’s a sliver of someone’s income compared to monthly insurance costs, “Which isn’t enough incentive to get young healthy people who think they don’t need insurance on a plan.”

Biby, 57, is an example of someone who struggled to find insurance before the Affordable Care Act due to an onslaught of preexisting medical conditions. He said he views medical care in the United States, and the insurance that secures it, a gift.

But he’s also one of the independent market consumers watching his health insurance rate rise. His Blue Cross Blue Shield bronze plan will go from roughly $930 a month this year to $1,704 in 2017.

“It’s a staggering jump, and means we’ll have to make sacrifices to afford it,” Biby said. “But what’s so frustrating isn’t Obamacare — it’s those people who aren’t buying insurance, who enjoy poking the eye of Obamacare without caring what it means for their neighbors.”

Michelle Harris listed what she had imagined her retirement would look like — occasional trips to sunny places with her husband and nice meals cooked in their kitchen.

She looked around her double-wide trailer in Columbia Falls. Family pictures hung on walls. Her dogs watched her movements from behind a child-protective gate blocking off the home’s one hallway.

“People think this is just piling on the rich, we’re not rich,” she said.

“We’re frugal people. You watch what you do, you buy clothes on sale, eat at home and then you write a check out every month for $1,400, wishing you were 65. It just messes with your mind.”

For more information or to consult with a local certified insurance agent, go to montanahealthanswers.com.

To shop for health insurance, go to healthcare.gov.

Reporter Katheryn Houghton may be reached at 758-4436 or by email at khoughton@dailyinterlake.com.