HELENA — State Auditor Monica Lindeen says she fully expects the federal government to have a health insurance “exchange” up and running in Montana next year — and that she hopes to streamline the compliance for insurers.
“Based on my knowledge and what I see happening, I believe (the feds) will have those up and running, on schedule,” she said in an interview late last week. “There’s nothing that leads me to believe that they won’t.”
The exchange is an Internet marketplace, where private health insurers will sell policies to individuals.
As part of federal health care reform, an exchange must be operating in each state by late 2013. Citizens who want federal subsidies to help pay for their policies starting in 2014 must buy off the exchange.
The federal law requires all citizens to have health insurance by 2014.
States can set up their own exchange or defer to the feds. The 2011 Montana Legislature, controlled by Republicans, rejected Lindeen’s request for state authority to start setting up an exchange.
Lindeen said federal health officials are designing Montana’s exchange, but that she has no details on what it will look like: “It’s all going on behind the scenes.”
A Health and Human Services official in Denver said Friday he also had no information about Montana’s exchange, and referred questions to HHS officials in Washington, D.C., who couldn’t be reached late Friday.
However, Lindeen said she has authority to have “plan management” of the exchange. Under that authority, Lindeen’s office would approve policies that can be offered on the exchange and enforce other regulations, rather than have the feds do the same thing and possibly duplicate regulation.
Lindeen, a Democrat, said she’ll consult with Democratic Gov.-elect Steve Bullock and incoming legislative leaders of both parties before exercising that authority – but if it would save companies and consumers money, she’s inclined to do it.
“I’d love to have their approval, but at the same time, I have a responsibility to protect Montana consumers, and I’m going to make sure I do that,” she said.
Lindeen said she’ll also be asking the Legislature, again, for authority to review health insurance rates in Montana.
Montana is one of only three states without such authority. Lindeen asked lawmakers two years ago to approve the authority, but the Republican majority refused, for the authority was seen as helping to implement the federal health law.
Yet Lindeen said last week that the authority is not tied to the Affordable Care Act, and can only help Montana consumers. Under current law, the federal government can review health insurance rate increases here, but Montana has no power to negotiate down increases found to be exorbitant.
Montanans insured by Time and John Alden faced premium increases that averaged 18 percent this year, and the federal government found that the increase was unreasonable. South Dakota was able to negotiate the increase for customers in the state down to 8 percent, she said, but Montana customers just had to pay it, because her office had no authority over the rates.
“Montanans are subsidizing lower rates in other states, and it’s unfair,” Lindeen said.