Montana to keep insurers in Affordable Care Act

Montana will be one of the few states holding onto its insurers in the Affordable Care Act as the nation faces a growing number of companies backing out of the program due to mounting expenses.

That means as health insurance costs continue to rise, Montanans will have more options than most states on where and how to get coverage when the fourth year of enrollment begins Nov. 1.

The cost of health insurance under the Affordable Care Act is expected to rise an average of 22 percent next year, according to information released by the Obama administration this week. That increase will affect about 80,600 Montanans on individual market plans.

At the same time, federal subsidies will also rise.

According to the state’s commissioner of securities and insurance, roughly 83 percent of Montanans on individual plans qualify for the tax credits.

Christina Goe, a general counsel with the commissioner’s office, said she’s worried as people hear reports of rising prices, they won’t look at their insurance options for next year.

“I think that the news sometimes grabs a headline, and then people don’t put it into the full context,” Goe said.

She said the tax break requirements leave about 35,000 Montanans who won’t get the break.

“Those who aren’t qualifying for tax credits, it’s tough for those people,” she said. “You have to look at the big picture — most people won’t see the increase … but people need to start shopping around for their insurance options.”

Plans are available on www.HealthCare.gov.

UNDER THE federal health law, insurance plans are classified in four levels — bronze, silver, gold and platinum — each varying in amount of coverage. The plan that sets and allows people to receive tax breaks is known as the silver benchmark plan, which offers the second lowest price for insurance.

In Flathead County, shoppers in individual market plans without a tax break will see the monthly premium cost of the benchmark plan grow from $449 in 2016 to $596 in 2017, according to a report released by the Associated Press on Thursday. That’s a 33-percent increase.

In comparison, before the Affordable Care Act was implemented in 2014, the benchmark cost in the Flathead hit $339. The year after, that cost lowered to $251. The next year, insurance consumers saw more than a 70 percent increase when the benchmark plan hit $449 a month.

The AP study was compiled by Avalere Health, a consulting company that has tracked the Affordable Care Act since its inception.

Caroline Pearson, the senior vice president of Avalere, said insurance companies are working to balance rates with the new shape the market took after the program went into effect. She said three major factors drove up the cost of the market.

First, she said the act allowed people who had previously been rejected for insurance due to an injury or illness to buy health insurance. Second, less people enrolled in the program than anticipated, meaning the growth in insured people largely came from those in need of health care.

“[The administration] hoped after 2014, healthier individuals would join the market and the risk pool would grow,” Pearson said.

But the numbers haven’t leveled out as expected, she said.

Lastly, a federal transitional Reinsurance Program that aimed to help stabilize premiums for coverage as sicker people were absorbed into the market will end this year.

THE STATE commissioner of securities and insurance office found that in 2016, roughly 7.4 percent of Montanans were uninsured. That number is down from 17 percent in 2014. Goe said there’s still another 76,000 Montanans out there without coverage.

A report sent out by the Centers for Medicare and Medicaid states that 80 percent of Montana Marketplace consumers will be able to find a plan with a premium of less than $100 a month. The report also stated if every returning Montana consumer selected the lowest plan available within their current level, average premiums in Montana would decrease by $43 a month.

Goe said sometimes people stick with previous insurance because they are willing to pay more for the plan or to maintain access to their current doctor.

Others simply don’t realize how important it is to shop around with insurance, she said.

People already on a plan need to pick a new option by Dec. 15 or they will be automatically renewed in their current plan or a similar one. Goe said the latter option may cause someone to miss out on a better deal.

“In the individual market, people are used to sticking with the plan they choose — that was really the requirement for so long,” Goe said. “But in this market, where rates are still stabilizing and plans are changing every year, people need to shop and update their choices every year.”

THE DAILY Inter Lake is interested to hear from local residents watching their health insurance premium rates increase for the 2017 enrollment period.

Email khoughton@dailyinterlake.com if you’re experiencing a growth in your premium costs without qualifying for the Affordable Care Act premium subsidies, and you’re interested in having your story heard.