More than 100K Montanans lose coverage as state Medicaid review continues

Montana Medicaid Dashboard
Posted at 6:19 PM, Nov 28, 2023
and last updated 2023-11-28 20:19:41-05

HELENA — Montana is now seven months into its statewide review of all Medicaid recipients’ eligibility, and updated data this week shows more than 100,000 Montanans have had their health coverage under the state Medicaid program terminated.

As of Nov. 21, the Montana Department of Public Health and Human Services reported it has gone through the redetermination process for 213,704 individuals. Of those, 104,097 – about 48% – didn’t have their Medicaid or Healthy Montana Kids coverage renewed.

Of the people who had coverage terminated, 31,918 were determined to be ineligible, while 65,897 failed to provide the information DPHHS requested when investigating their eligibility.

Since the start of the redetermination process, DPHHS has been working with Cover Montana, a program of the Montana Primary Care Association, to inform those who’ve lost coverage about their options for getting health insurance. One of those options has been to turn to the individual health insurance marketplace, established through the federal Affordable Care Act. Open enrollment through the marketplace opened on Nov. 1.

“There are always Montanans who are uninsured, who really need to pay attention to open enrollment to make sure that they're shopping around and taking the time to see what they qualify for,” said Olivia Riutta, director of Cover Montana. “This year, there are just more Montanans who need health insurance coverage.”

Riutta says Cover Montana has been informing people about what health coverage they’re eligible for and helping them with enrollment for ten years, and this year, they’ve seen a growing demand for those services.

“It has by far been the busiest year that we have ever seen, since the first open enrollment period,” she said.

Open Enrollment Update

Last week, a report from the federal Centers for Medicare and Medicaid Services said 10,998 Montanans had signed up for health plans through since Nov. 1. That’s up from 10,030 over the same period in 2022.

People who lost coverage due to Medicaid redeterminations did not necessarily have to wait until open enrollment to get a plan through They are eligible for a special enrollment period that runs from when their Medicaid or HMK expires through the summer of 2024. However, Riutta said it appears many people are now paying more attention to health coverage because of the open enrollment period.

MTN reached out to some of the companies that provide plans through the individual marketplace in Montana. John Doran, divisional vice president of external affairs for Blue Cross and Blue Shield of Montana, said BCBS ran marketing campaigns aimed at Montanans who lost coverage because of Medicaid redeterminations. He said they saw a steady increase in marketplace enrollments through the late summer, but month-over-month increases have slowed in the fall. Doran said, in addition to redetermination, many of the inquiries they got were related to job losses.

Mountain Health Co-Op serves members in Montana, Idaho and Wyoming, and leaders told MTN they’ve seen a rise in membership in all three states that they attribute to people transitioning off Medicaid. They said that includes a recent surge at the start of open enrollment.

The open enrollment period will continue through Jan. 15, but leaders encourage anyone interested in getting a plan through the marketplace to enroll by Dec. 15, so they will have coverage starting Jan. 1.

Riutta said the main questions Cover Montana gets about market plans is whether they’ll be affordable, but that most people will qualify for some form of additional support. She said 87% of Montanans who enroll in a plan through receive tax credits to make their monthly premiums more affordable, and that about a quarter get plans with reduced out-of-pocket costs.

“We want to make sure that if folks need coverage, if they're not sure, to reach out and make sure they're having a conversation with someone to see if they, in fact, should take the time to apply,” said Riutta.

If you have questions about coverage options or you’d like assistance with the enrollment process, you can find more information on Cover Montana’s website. You can also call their Help Line at (844) 682-6837.