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Montanans buying health coverage on individual market can still get 2019 fed subsidies

Posted at 5:02 PM, Dec 03, 2018
and last updated 2018-12-03 19:52:22-05

HELENA – While Republicans in Congress and President Trump have whittled away at elements of “Obamacare,” health insurers in Montana say one key component is still rolling along: Subsidized policies on the individual market.

The 50,000-plus Montanans buying on this market have until December 15 to sign up for a policy and, if they’re eligible, get federal subsidies to help pay for it.

Earlier this year, Republicans in Congress repealed the federal mandate that all citizens have health insurance.

But officials with the three insurers selling policies in Montana say signups for 2019 policies have been poking along since Nov. 1, and that they expect the final numbers to be similar to last year.

Richard Miltenberger
Richard Miltenberger, Montana Health Co-op

“I’ve been optimistic,” Richard Miltenberger of the Montana Health Co-op told MTN News. “What’s really driving this is not the mandate. What’s really driving this is the subsidies, and the subsidies are still there.”

The other two companies selling on this market in Montana are PacificSource and Blue Cross and Blue Shield of Montana.

This year, about 55,000 Montanans have purchased individual health policies – a small yet significant piece of the overall health-insurance market in the state.

Most of those were purchased through the federal Internet “marketplace,” on the website, created by the 2010 Affordable Care Act (ACA), or “Obamacare.”

Those earning up to 400 percent of the federal poverty level – about $66,000 for a couple – may be eligible for a subsidy to help pay their premiums, if they buy on the website. The subsidy offset is paid directly to the insurer.

In Montana, about 85 percent of the people buying on the website have been eligible for a subsidy.

Miltenberger said the subsidies can end up covering large portions of the policy cost. About 20 percent of the Co-op’s customers have net premiums below $50 a month, he said.

Without the subsidies, the policies aren’t cheap.

A “bronze” policy, the least expensive type, costs anywhere from $314 a month for young adults to $1,200 a month for someone who is 64. Deductibles often range from $5,000 to $7,000 a year.

For 2019, the Trump administration has OK’ed less-expensive alternatives: so-called “short term” policies that are good for nearly a year but may cover fewer things.

John Doran
John Doran, Blue Cross & Blue Shield of MT.

John Doran, a Blue Cross and Blue Shield executive in Helena, said consumers should “read the fine print” to make sure whatever policy they buy covers the services they want.

Doran said enrollment at Blue Cross for the individual plans has been “steady” and that the company is hopeful they’ll come close to last year’s numbers on policyholders.

“We don’t know what to expect yet, from the elimination of the individual mandate,” he said. “So, time will tell. … A lot of people understand that value of having a health-insurance plan, whether it’s access you get to primary care, or that financial safety net you have in times of crisis.”

PacificSource, which insures about 12,000 people on individual policies in Montana, also told MTN News that it expects similar signup levels this year.

Todd Lovshin, Montana regional director for the company, said rhetoric during the election and a lack of coverage of the enrollment window has left some people confused about whether the subsidies and the marketplace still exist.

He encouraged consumers to contact the company, agents or coverage advisers with any questions about the policies or signups.

The Co-op insures just over 22,000 Montanans on individual policies; Blue Cross has about 20,600.

— Story by Mike Dennison – MTN News