The Health Care Marketplace

Jul 26, 2013

Beginning on October 1st of this year, just about 2 months away, Montana and the rest of the country will begin a process which will radically change how many people shop for and buy health insurance.

Most people have heard of the Affordable Care Act, or Obamacare, though a survey just a month ago showed that up to 40% of Americans still believe that it has been repealed or is not going to take effect.  This points out the problem of a major new law which many people simply don’t understand.  The ones who could benefit the most are probably the least likely to get it.

Education about what all this means and easy access to actually buy health insurance will be essential to making the whole thing work.

In Montana, there will be three health insurance companies offering products on what is being called the health care marketplace.  This was previously called the exchange.  Each state has different insurance companies offering products for that state’s marketplace.  Some areas may have a choice of up to 15 different plans, while other states will have just one company offering insurance.   Starting October 1, anyone will be able to go to the internet site and see what is being offered in each state and how much it will cost to buy health insurance from the different companies.  The options will range from relatively inexpensive catastrophic coverage for young and healthy people, all the way up to very comprehensive but more expensive insurance. 

A major part of this whole program is that no-one can be denied insurance coverage because of an existing illness.  Rates will be different depending on age, but everyone in the same age range will pay the same amount.  Smokers may be charged more.  Medicare is not affected, and people who are now getting health insurance through their work will mostly not be affected either. 

In our state there will be a group of poor people who still will not be able to buy health insurance.  Our legislators made a choice not to provide Medicaid insurance to individuals earning less than the federal poverty level, which is about $11,400/year for an individual.  People earning more than this may receive significant financial help to cover the cost of buying health insurance.  For example, with these supplements, young people earning $15,000 a year may be able to purchase insurance for less than $15/month.  The higher the income, the older the person, and the more comprehensive the plan, the more it will cost.

Still, compared to the current cost of individual health insurance, the cost of the insurance through these marketplaces, even without subsidies, is looking like it will be significantly less.

To help us all understand exactly what we will need to do to sign up, there will be folks around who are trained to lead people through the process.   Many should be able to do it themselves on the web at  Right now you can get many of your questions answered at this site.  Starting in October, this is where you will go if you want to actually look at your Montana options and buy insurance. The Montana Health CO-OP web site has a simple calculator which helps you figure out about how much financial help you can expect to get based on income, age, and family size. 

Our state insurance commissioner Monica Lindeen will have information on the insurance department web site.  A number of people will be specially trained to lead others through the signup process.  Many insurance agents will become certified to help individuals, families, and businesses sign up.  Counselors will be trained and available in many of our health clinics and state offices.  People called Navigators will have extra training and will be in most major Montana communities. 

Overall, we expect to see well over 100,000 Montanans eventually use these services.  Many of these people currently have no insurance, or are buying very expensive insurance with high deductibles.  Some small businesses may decide to drop their employer based insurance and instead pay their employees a little more to purchase insurance on the marketplace.  We do expect it to take some time, but finally we are going to make insurance available and affordable to many people who have been left out.  Hopefully, our state legislators will see the benefits of this for all Montanans and work for ways to provide this insurance to the 50,000 people who will not qualify without federal help through an expanded Medicaid program.