HELENA — A program that helps Montanans applying for health coverage says it will need to significantly scale back its work, after losing much of its federal funding.
“It's pretty heartbreaking to lose the grant, because we know that folks always have questions about health insurance coverage,” said Olivia Riutta, director of Cover Montana.
(Watch the video for more on what's next for Cover Montana.)
In February, the federal government cut 90% of the funding for the Affordable Care Act Navigator program. They argued the program cost too much and wasn’t effective enough at getting people signed up for coverage through the federal health insurance exchanges.
Cover Montana, a program of the Montana Primary Care Association, was awarded a five-year grant in 2024. They were initially scheduled to receive $1.25 million for the next year, but that was cut to $125,000. Riutta says they applied for other competitive federal grants to fill some of that gap, but they weren’t successful.
Now, starting in September, they’ll have to lay off staff who have worked one-on-one with people applying for Montana Medicaid or marketplace health plans.
“The biggest shift is that we can no longer offer in-person help to folks,” said Riutta. “We can help folks over the phone or virtually, but our staff who can do that – provide that enrollment help – is very small. So we are going to answer as many phone calls as we can and help as many Montanans as we can, but it is a very small team when compared to the demand that we’ve seen throughout the year.”
Riutta said they’ve always seen a lot of demand for these services around the open enrollment period, but in the last year, they’ve been busy for much longer. She said that’s partly because of people losing Medicaid or employer-sponsored health plans and looking to find coverage on the marketplace.
“There's a lot of big shifts happening right now, at the federal and the state level, with both Healthcare.gov and Montana Medicaid,” Riutta said. “When changes happen, people have questions, and they need help through that process. And so, it is really unfortunate that this is happening now at a time when we know Montanans have a lot of questions.”
According to data from the federal Centers for Medicare and Medicaid Services, Cover Montana was responsible for enrolling 3,570 consumers in marketplace health plans in 2024 and helped another 20,201 enroll in Medicaid or CHIP.
Riutta said Cover Montana had 18 full- and part-time staff, including contracted workers who staffed a helpline. Going forward, they’ll have funding for less than two full-time-equivalent employees.
She said they’ll continue to answer phone calls, but they may not be able to get to everyone.
“In our experience, Montanans like to call Montanans, and they want to have a conversation with someone who understands them and understands the plans sold in the state of Montana,” said Riutta. “So it is not ideal, but we'll send folks back into the marketplace call center and they can apply over the phone that way.”
Cover Montana is also putting together more guides on their website, to help people work through the application process themselves.
Open enrollment for health insurance begins Nov. 1, and the Montana Commissioner of Securities and Insurance’s office has said rates for many plans on the health insurance marketplace are expected to rise. Riutta said it will be important for people to shop carefully when picking a plan this year, so they know what the costs and benefits will be.
“Our message to everybody is make sure you update your application come Nov. 1, and make sure you give yourself the time to shop around for a 2026 plan,” she said.
