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BILLINGS - The Affordable Care Act is complex, part of the act is already in effect and more changes are on the way, according to Blue Cross Blue Shield of Montana, which made a presentation on how the law will affect Montanans in Billings on Thursday.

"The message is that it's a very complex law and communication is absolutely crucial," said Shawn Jacobs, director of consumer sales at Blue Cross Blue Shield of Montana.

The Patient Protection and Affordable Care Act, passed by Congress in 2009, takes effect in 2014.

"The taxes and the penalties and the subsidies and the money and where does all the money go, that certainly seems in what we've seen today," Jacobs said. "That is the top question on everybody's mind: where am I going to fit based on my income?"

"One of the concerns is that it's going to likely cause some in creases in premiums," said Chris Herriges, associate general counsel for Blue Cross Blue Shield of Montana. "Just because of the increases benefits and the changes in the way products have to be rated and that sort of thing."

Herriges says while there are uncertainties with the act, one certainty is that it is the law.

"Before the Supreme Court spoke, we still considered it to be the law of the land and enforceable," Herriges said. "Regardless of how the elections turn out, it is still the law of the land at this point and we are still continuing of our implementation efforts."

And they have advice in preparing for the law. "Consumers need to stay apprised as we march towards 2014 try to figure out exactly what's going to be best for them and their family," Jacobs said.

"The one constant would be to continue to expect change," Herriges said.

"We've had key regulations in the past," Jacobs said. "This is by far the biggest challenge for the health care market, not just Blue Cross Blue Shield, but for health care overall."

An attorney from the state auditor's office also was on hand to answer questions.

Blue Cross Blue Shield and the auditor's office also held a similar forum in Bozeman Thursday, and next week they'll take their show on the road to Missoula and Great Falls.