For the 50,000 Montanans still buying health insurance on the federal “marketplace,” rates for 2019 policies may be going up slightly or not at all, MTN has learned.
Also, federal subsidies likely will continue to offset the cost for the vast majority of people buying the individual policies next year in Montana.
“It’s somewhere in the 85 percent to 90 percent of Montanans, that buy health insurance on the exchange, that get a subsidy,” said Richard Miltenberger, CEO of the Montana Health Co-op. “We don’t see that changing in 2019.”
The Health Co-op is one of three companies selling policies through the federal online marketplace, which was created by the 2010 Affordable Care Act (ACA), also known as “Obamacare.”
The others are PacificSource and Blue Cross and Blue Shield of Montana.
The three companies filed their proposed rates for 2019 marketplace policies on Thursday. The proposed new rates won’t be made public for a couple of weeks, but sources told MTN News the average percentage increases range from around zero to the low double digits.
This summer, state Auditor Matt Rosendale’s office will hold hearings on and examine the rates.
Montanans who don’t have health coverage through their job or elsewhere can buy an individual policy through the online marketplace and, if they’re eligible, get a federal subsidy to help pay for it. Subsidies are available for most consumers who earn up to 400 percent of the federal poverty level, which is about $48,000 a year for a single person and $65,000 for a couple.
Although President Trump and Republicans in Congress have tried to repeal the ACA and made some changes in the rules and financing, the basic framework of the ACA remains largely intact for individual health-insurance policies.
However, there is no longer an individual mandate for people to have health insurance.
Miltenberger and other Montana insurers said the absence of the mandate may have some impact on the market, but he said he expects not many people will drop their coverage, because so many will still get subsidies to offset the cost.
“I would suggest that the majority of consumers value health care, they value health insurance, and they’re going to continue to participate,” he said.
Todd Lovshin of PacificSource said the company will be doing its best to persuade consumers to maintain their coverage, mandate or not.
“We really encourage them to take a look at health insurance as a mechanism of financing their health care,” he told MTN News this week. “It takes only one broken leg, or an emergency room visit, to really ruin your financial plans."
Another change in the offing is the availability of short-term individual health-care policies that do not cover the “essential benefits” required by the ACA. A short-term policy is anything less than a year.
The president issued an executive order to allow these policies that cover fewer things, but the federal rules are still being drafted.
Rosendale, who opposes the ACA, said he supports this change, because it will give consumers more affordable options for health coverage.
The three health insurers offering policies on the marketplace in Montana said they haven’t decided whether they will offer these short-term policies with lesser coverage.
John Doran, a spokesman for Blue Cross and Blue Shield of Montana, said such policies “typically don’t cover a lot.”
“Consumers need to be really careful when looking at these plans, to make sure they cover the necessary services,” he said.