By Louise Norris
March 30, 2014
Open enrollment in Montana ends on March 31. But HHS is allowing an extension for applicants who begin the process by that date, but are unable to complete their enrollment by the end of the day on March 31. The extension is expected to be valid until mid-April, and applicants will have to attest to the fact that they tried to enroll by March 31 but were unable to finish because of technical problems or other extenuating circumstances.
By March 1, private plan enrollments had been completed for 22,542 Montana residents. Another 3,643 people had qualified for the existing Medicaid program in Montana.
Montana’s legislature not only failed to authorize a state-run exchange, it also passed a bill in 2011 to prohibit the creation of an insurance exchange in Montana. While Democratic Gov. Brian Schweitzer vetoed that bill, neither he nor Monica Lindeen, the state auditor and insurance commissioner, were able to generate legislative or public support for an exchange. Consequently, the federal government is operating the exchange in Montana at Healthcare.gov. Montana is also one of nineteen states that has passed laws making it more difficult for people to serve as navigators for the exchange.
Montana also opted out of expanding Medicaid (unfortunately, it was an accidental “no” vote that doomed the expansion effort, but there’s no way to undo such a vote after it happens). The governor’s office is supportive of some aspects of Medicaid expansion, but no steps are likely to be taken towards expansion until at least 2015/ And on the other hand, opponents of the ACA were gathering signatures in late December for a ballot initiative that would block Medicaid expansion, prevent the state from spending any money to enforce ACA rules, and would go so far as to provide a tax credit to any residents who owe a penalty under the shared responsibility (individual mandate) provision of the ACA.
On November 25, Lindeen announced that Montana would allow health insurance carriers to extend 2013 policies that had been scheduled to terminate at the end of the year, but it was left up to each carrier to decide how to proceed. Insureds who have a policy that is allowed to renew into 2014 also have the option of switching to an exchange plan.
Residents in Montana can select from three health insurance carriers within the Montana exchange: Blue Cross Blue Shield of Montana, PacificSource and the Montana Health Co-op. The Montana Health Co-op was created under the co-op provisions of the ACA, and was one of the first seven co-ops to receive federal funding in early 2012. The lowest cost bronze plan in the Montana exchange averages $251/month, which is very close to the national average of $249. All three insurers agreed to extend the initial payment deadline for January. Applicants who selected their plans by December 24 are eligible for a January 1 effective date. BCBS of Montana and the Co-op are giving applicants until January 10 to pay the first premium, and PacificSource will accept January premiums as late as January 15, for coverage retroactive to January 1.
Under the federal model, most aspects of the exchange are managed by the federal government. However, states can retain control of “plan management” functions, and Montana opted to do so. Lindeen’s office released final rates for the exchange in mid-August, nothing that the premiums are similar to what they would have been without the ACA. Her office regulates plans that operate on the exchange, as it does for plans sold outside the exchange.
Three organizations in Montana received federal grants in August to serve as navigators and assist residents with the enrollment process: Planned Parenthood, Montana Primary Care Association, and the Montana Health Network. Consumers may contact any of these organizations in order to ask questions or receive personal help with enrollment.
According to Kaiser’s statehealthfacts.org, about 180,000 people — 18 percent of the population — in Montana do not have health insurance.
State Exchange Profile: Montana
The Henry J. Kaiser Family Foundation overview of Montana’s progress toward creating a state health insurance exchange.
Montana Consumer Assistance Program, Office of the Commissioner of Securities and Insurance
Serves as the state government watchdog for citizens of Montana in the insurance industry
Health Insurance Exchange Page from Montana Commission of Securities and Insurance
Details about how the exchange works, along with legislative history in Montana regarding the exchange creation process.
Let your Montana governor and legislators know how you feel about the state’s proposed health insurance exchange.Montana Governor Steve Bullock