Viewpoint: Ten years of connecting Montananers to health insurance coverage

Olivia Riutta is the director of population health at the Montana Primary Care Association.

This month marks a decade for Montana’s Health Insurance Marketplace and Before the Affordable Care Act, one in five Montananers were uninsured and lived with insecurity and lack of access to health care. So, on this 10th anniversary of the marketplace, we’re celebrating ten milestones over the past decade.

#10: Remember the crash? Don’t worry, it works now!

We’ve been with Cover Montana since the beginning and remember the first open enrollment period when the site crashed. The site has come a long way and we are happy to report that it is working well! With just one application, you can enroll in a Marketplace plan, Healthy Montana Kids, or Montana Medicaid.

#9: Bye-bye already existing disease exclusions

The ACA eliminated pre-existing disease exclusions—a godsend for Montanans with conditions like asthma, diabetes, or cancer survivors. And to make it even better, these protections extend to non-marketplace plans as well.

#8th: Medicaid Extension!

Since Montana expanded Medicaid in 2016, Medicaid has been an affordable, comprehensive health insurance option for 100,000 Montanans. During the pandemic, Medicaid has done its job of making sure thousands of people who have lost their jobs and faced reduced hours have access to medical care.

#7: Free preventive services

With the ACA came a free preventive service. Now insurance pays full price for certain screenings and preventive measures like annual checkups for women, vaccinations, and screening for things like colon cancer.

#6: In 2022, the number of Marketplace signups will surpass 51,000

On January 15, the last open enrollment period ended, and Montana had more than 51,000 enrolled for coverage. This is an increase of 14% compared to the previous year.

#5: Marketplace plans are more affordable than ever (really)!

The American Rescue Plan Act (ARPA), the major COVID legislation of 2021, made Marketplace plans even more affordable and removed the cap on tax credits. Annual savings are more than $800 per person who signs up for a Marketplace plan.

#4: New special registration period for people below 150% poverty

This new special filing period allows individuals to enroll outside of the annual open filing period if they are at or below 150% of the federal poverty line. Now, a single person making $19,320 a year or a family of three making $32,940 can still be insured.

#3: Special provisions for enrolled tribe members

The ACA contained several special conditions for enrolled members of a federally recognized tribal nation. First, enrolled members can be insured year-round, not just during open enrollment. No-sharing and limited-sharing plans are also available, making access to care much more affordable.

#2: Plans cover essential health benefits

All Marketplace plans and most non-Marketplace plans must cover the 10 Essential Health Benefits. This includes everything from emergency services, maternity insurance, prescription drugs, mental health and more.

#1: Uninsured rate halved

Before the ACA, one in five Montaners had no health insurance. Now that rate is one in ten.

Montana is proud of many things, from major achievements like halving the uninsured rate to helping more than 5,500 people on Medicaid get in-patient treatment for a substance use disorder. But there is still a lot of work ahead. Children are still uninsured in Montana, and we will continue to work in communities across the state to ensure all of our neighbors have the information and support they need to be insured. It’s been an incredible decade and Cover Montana has been a proud partner.

Olivia Riutta is Director of Public Health for the Montana Primary Care Association and directs Cover Montana, a statewide program designed to bring Montanans into coverage.

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