HELENA — Come this fall, thousands of Montanans without health insurance are supposed to be able to shop via the Internet for a policy — and find out if they can get government subsidies to help them pay for it.
This Internet shopping center is what’s known as a health insurance “exchange” or marketplace, which is already under construction for Montana — courtesy of the federal government. It’s part of the Affordable Care Act, the 2010 health care law supported by President Barack Obama and Democrats in Congress.
Federal health officials aren’t releasing specific details on Montana’s exchange, and say only that it will be ready by October and have policies for individuals and small businesses.
Yet health insurers and consumer groups in Montana gearing up for the launch of the exchange say they have an idea what it may look like, and are doing what they can to get the word out.
“For anyone who would listen, we’d love to tell the story of Obamacare,” said Jerry Dworak, CEO of the Montana Health Cooperative, a new nonprofit health insurer that will sell its policies on the exchange. “Whether (people) take our plan or another plan, they’d be foolish not to take advantage of them.”
The exchange will offer an array of health insurance policies from private companies, for purchase by those without coverage. The law says everyone must have insurance by 2014 or pay a tax penalty.
If you want government subsidies to help pay for your policy, you must buy it on the exchange. The subsidies are available for people earning up to 400 percent of the federal poverty level. That’s nearly $46,000 for a single person.
States had the option of putting together their own exchange, but Montana’s 2011 Legislature refused to grant that authority to Monica Lindeen, the state auditor and insurance commissioner.
Majority Republicans at the 2011 Legislature said they wanted nothing to do with implementing “Obamacare,” and hoped it would be thrown out by the U.S. Supreme Court or otherwise dismantled.
The Supreme Court, of course, upheld most of the law and, with Obama’s re-election, its mandate for all Americans to have health insurance by 2014 apparently won’t be undone.
States had until Feb. 15 to say whether they would partner with the federal government on the exchange, but Lindeen, a Democrat, said she had no authority to do so.
In an interview late last month, Lindeen said her office will review health insurance policies that are sold on Montana’s insurance marketplace, but as far as constructing the exchange, “we will not be building anything.”
Five of her staffers, however, are attending “simulation meetings” this month, where federal officials will give demonstrations on how the exchanges will work in Montana and elsewhere.
Dworak said the feds in January came out with a website model, showing how individuals will enter personal information that determines their eligibility for subsidies or other coverage.
The model can be seen on the website of a nonprofit organization, Enroll America, which was set up by groups supporting the Affordable Care Act. A link to the website is here: http://www.enrollamerica.org/blog/the-single-streamlined-application-is-here.
The next step will be linking the eligibility and subsidy determination to the actual shopping for a qualifying health insurance policy.
“They haven’t released anything on that, but I’m sure they’re working on that now,” Dworak said. “It’s moving along.”
Insurers are supposed to say by March or April whether they want to offer policies on the exchange.
Spokesmen for Blue Cross and Blue Shield of Montana and PacificSource, two of the biggest health insurers in Montana, said the companies plan to offer policies on the exchange. Allegiance Life & Health Insurance Co., based in Missoula, said it’s “carefully reviewing its options” regarding the exchange.
Todd Lovshin, Montana regional director for PacificSource, said he doubts the Montana exchange will be much different than what the feds are constructing for other states that chose not to do their own.
“They don’t have time to customize it for Montana,” he said. “We expect to hear some things in early March on how to be a qualified health insurance plan (offered on the exchange), on the filings, and what the forms will look like.”
Meanwhile, consumer groups in Montana are trying to inform people about the exchanges and opportunities for coverage under the new law.
Montana Farmers Union is holding public seminars across the state, talking about the Montana Health Co-op and the exchanges, and staffers with the Center for Rural Affairs have been talking to local business groups and others.
However, officials from both groups say few people are attending the meetings, and said they’re concerned about a lack of interest or knowledge about the exchanges, and what they can offer.
“In the meetings that we have done, we’re by no means packing the room,” said Steph Larsen, assistant director of organizing for the Center for Rural Affairs. “I’m concerned … that October is going to come and people won’t take the opportunity to sign up, because they don’t understand how it works.
“This has the potential to make health insurance so much more affordable for so many more Montanans.”