A year ago, the new federal health insurance exchange failed at its debut. Millions of Americans were unable to use the promised online signup and couldn’t get through to telephone help centers. About 36,000 Montanans still managed to buy private insurance policies through the exchange.
Jade Jagers, a certified application counselor at RiverStone Health in Billings, struggled through the healthcare.gov glitches last November, but hasn’t seen problems this year.
“The very first person I helped at 9:30 the first morning got enrolled. It worked,” Jagers said last week. So far, Jagers and two other RiverStone health care exchange counselors have worked individually with about 100 people interested in individual insurance policies for 2015.
Those shoppers are finding very slight increases in plan prices. The average rate increase for Montana exchange policies is 1.35 percent, according to an independent actuary hired by Monica Lindeen, Montana commissioner of insurance. Nationally, health insurance rates are expected to increase 8.5 percent on average.
Importantly for Montana customers, the mid-range silver plans (the most popular type of plan here) will be increasing on average only 1 percent in 2015, according to the analysis.
That analysis looked at plans offered for 2014 and 2015 by Blue Cross Blue Shield, The Montana Health Co-op and PacificSource. Another company, Assurant, has entered the Montana marketplace this year.
If you or members of your family don’t have health insurance, you owe it to yourself and your loved ones to check out the 2015 marketplace. Between the four insurance companies, 40 bronze, silver, gold and platinum plans are being offered, plus three catastrophic plans available only to people under age 30.
Last year, 80 percent of the Montanans who bought marketplace individual policies qualified for a federal subsidy to reduce their costs. Who is eligible for premium subsidies?
- People with income between 100 percent and 400 percent of poverty level ($11,670 to $46,680 annual income for one person.)
- People with incomes between 100 percent of poverty and 250 percent ($29,175 annual income for a single person) also qualify for reductions in their plan deductible and in their annual out-of-pocket-maximum responsibility.
- Native Americans can qualify for federal subsidies that eliminate their chosen plan’s deductible and out-of-pocket maximum, so that they only pay the subsidized monthly premium. This benefit is available to tribal members whose income is between 100 percent and 300 percent of poverty level (about $35,000 a year for a single person).
This all sounds complicated.
“There are so many different variables,” agreed Barbara Schneeman, RiverStone vice president for communication and public affairs. “Application counselors will help you do calculations so you can make better choices for you.”
Small wonder that Montana health care providers, such as RiverStone and community hospitals, are providing free application counselors. Patients who don’t have insurance account for most of the charity care and bad debt these organizations have to cover – by charging other patients more.
Last year, about 52 percent of RiverStone patients were uninsured.
Folks who are reluctant to accept an insurance subsidy for their individual policies ought to keep in mind that Americans covered by employer group plans have long enjoyed a federal subsidy for their insurance. Employer group premiums are deductible from income tax liabilities. The Affordable Care Act provides a break to folks who don’t get the other tax break.
Critics point out that requiring everyone to have insurance means the healthy pay for the sick. That is true of all health insurance plans. A small fraction of enrollees accounts for the bulk of expenditures in Medicare, Medicaid and private group insurance plans.
All of us are at risk for accidents and illnesses. Catastrophic medical bills have long been the No. 1 reason Americans file for bankruptcy.
Protect your family by obtaining insurance. The exchange is a good place to start shopping, but don’t wait. Dec. 15 is the last day to enroll for coverage starting Jan. 1.
Date: December 1, 2014