Guest opinion: ACA benefits add up to healthy gains for Montanans

2014-07-13T12:00:00Z 2014-07-13T15:56:03Z Guest opinion: ACA benefits add up to healthy gains for MontanansBy BOB MARSALLI The Billings Gazette
July 13, 2014 12:00 pm  • 

The Affordable Care Act is working and the evidence continues to mount.

The most recent proof comes from a report showing that, on average, Montanans receiving tax credits for their health insurance saved more than 70 percent on their premiums this year. Instead of forking over $345, they paid only $99 a month.

That’s good health care for less. It’s more money for groceries, gas or school. And it leads to stories like Sue Spanke’s, which was reported by Lee Newspapers. Thanks to the law, Sue, who lives in Missoula, found a plan with federal support that lowers her premium from $350 to as low as $30 and her deductible from $5,000 to $500.

Not a bad deal for making a few phone calls, filling out some forms, and a little perseverance.

When the health care.gov website had its rocky roll out last fall, critics were quick to pounce. But the website wound up doing its job: connecting Americans with more options for high-quality care. And the recent news about savings from tax credits means they didn’t have to empty their wallets to get it.

Before the insurance exchanges opened in October, advocates of health care reform promoted the law’s other benefits, like making prescription drugs more affordable for seniors by closing Medicare’s “donut hole” and allowing kids to stay on their parents’ health care plan until they turn 26.

Seniors save on meds

Well, these benefits continue to make a difference, too. In 2013, nearly 11,000 Montana seniors saved close to $8.6 million on prescriptions drugs. That’s more than $780 per person. Additionally, 12,000 young Montanans were able to keep health care coverage by staying on their parents’ plan.

We also can’t forget that the Affordable Care Act prevents most insurers from denying coverage because of a pre-existing condition. With up to 425,000 non-elderly Montanans having some type of pre-existing condition, including asthma or diabetes, that’s a lot of people getting better access to care.

Another popular provision is what’s known as the “80/20” rule that requires health insurance companies to spend at least 80 cents of each premium dollar on health care, rather than administrative costs like salaries or marketing – otherwise they have to provide customers with a refund.

Premium refunds

As a result, more than 13,200 Montanans with private insurance coverage benefited from more than $1.5 million in refunds in 2012, for an average of $173 per family.

Expanding Medicaid would also help 70,000 low-income Montanans who need health care, but cannot afford it.

We should be supporting more ways to ensure all Montanans have quality health care. I join every Montanan who will continue working to expand Medicaid in our state in order to create jobs and make Montana a healthier place to live and work – while also driving down the cost of health care for everyone by reducing the number of uninsured veterans, elderly, and working adults.

That makes good business sense, too, which is why local Chambers of Commerce across Montana have endorsed Medicaid expansion.

As the head of the Montana Primary Care Association, some of the most compelling evidence I see that the Affordable Care Act is working comes from the Montanans our 17 community health centers have enrolled. One woman we helped had Type I diabetes and needed a new insulin pump. The mother of two young children, she and her husband had been uninsured for years, due to skyrocketing costs and pre-existing condition exclusions. She was overjoyed and relieved to finally have affordable access to the health care she needs.

Let’s keep fighting for Montanans like her. Let’s keep fighting for better access to and quality of care. Let’s keep fighting to ensure every Montanan has the opportunity to lead a healthy, prosperous life.

Let’s start seeing the progress the Affordable Care Act is making in our state.

Bob Marsalli of Helena is chief executive officer of the Montana Primary Care Association.

Copyright 2014 The Billings Gazette. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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