Editor’s note: This story is the second of a two-part series on Montana’s new health insurance marketplace, a key component of the Affordable Care Act, President Barack Obama’s signature health-care reform law.
HELENA — From state officials to the Montana Chamber of Commerce, many organizations are gearing up to help Montanans cope with a health care game-changer: The launch of the health insurance marketplace, a key component of federal health care reform.
“I would say every person we’ve come into contact with, almost none of them understands the (marketplace),” says Tom Jacobson, executive director of Rural Dynamics Inc., a group advising working Montanans on financial issues. “It’s one of the biggest, yet least-known aspects of the Affordable Care Act.”
Next year, Americans who don’t already have health insurance will be required to buy it or pay a tax penalty.
Those earning up to 400 percent of the federal poverty level can get subsidies to help them buy that insurance — but only if they buy the policy on the new Internet marketplace, also known as the exchange.
The federal government is scheduled to open the marketplace for Montana on Oct. 1.
Three companies — Blue Cross and Blue Shield of Montana, PacificSource and the new Montana Health Co-op — will be selling health insurance policies on the marketplace.
The marketplace also may affect how businesses offer health coverage, as some could decide to drop employee coverage and have workers buy subsidized policies on the marketplace.
The federal government and groups close to President Barack Obama say they’re mounting their own massive public-relations push, to get people without health insurance to sign up for it through the marketplaces.
But their presence has been minimal in Montana, and plenty of local entities are stepping into the void.
Montana’s insurance commissioner, Monica Lindeen, is preparing a website, which should be ready within the next two weeks, to help Montanans navigate the new Affordable Care Act landscape.
Lindeen’s office also will invite Montanans to ask any specific questions they have, through the website or by telephone, and is promising an answer within three business days.
“The ACA is a large, complicated piece of legislation, and Montanans rightly have a lot of questions on how it will affect them,” says Jennifer McKee, spokeswoman for Lindeen’s office.
Private consultants are busy advising their clients and, at times, the general public, on how to react to the rollout of the exchanges.
Richard Miltenberger, a partner with Mountain West Benefits of Helena, which advises businesses on health insurance plans, says his company has conducted 50 in-person or web-based seminars on the marketplaces.
He says he generally finds “a complete lack of understanding of how the (marketplace) works.”
“Most Montanans don’t understand that this is just as simple as going to Amazon and comparing apples to apples,” he says. “They think it’s government insurance, which it’s not. Or they think you’re only eligible to get insurance on the (marketplace) if you have special conditions.”
Starting Oct. 1, anyone can shop for health insurance on the marketplace and buy a policy from one of three private insurers.
Nonprofit groups also are getting involved in the effort.
The Center for Rural Affairs, which has an office in Missoula, has been distributing newspaper columns and conducting other outreach, and Rural Dynamics of Great Falls has applied to the federal government to become a “navigator,” which is a non-insurance group that will help educate Montana consumers about the marketplaces.
The federal government has $600,000 to fund navigators in Montana, and will announce grant recipients in August.
Steph Larsen, assistant director of organizing for the Center for Rural Affairs, says the biggest problem she encounters is that people have been “barraged with inaccurate information,” and don’t know where to turn for good information.
For example, a national poll this spring showed 42 percent of Americans weren’t sure the ACA was still in force, or thought it had been repealed, she says.
Larsen also cautions that in rural Montana, promoters of the Internet-based marketplaces need to realize that easy Internet access is not a given.
“It could be difficult for people in rural Montana,” she says. “Not everyone has a computer. Not everyone is tech-savvy.”
Kathleen Stoll, director of health policy for Families USA, a national consumer group and major supporter of the ACA, says national groups behind the law are planning their big public-relations push this summer, timed to coordinate with the Oct. 1 launch of the marketplaces.
“We have a significant mountain to climb to let people know what’s coming, and that they can begin signing up Oct. 1,” she says.
Jacobson of Rural Dynamics agrees, and says Montana stands to benefit from the marketplaces because it has a lot of lower-wage workers who should be eligible for substantial subsidies to buy health coverage.
“I really think we need to get the public talking about this,” he says. “But people don’t want to talk about things that they don’t understand. We have to get them to understand the ins, the outs, the options. …
“We need to have neighbors talking across the fence about what type of policy they bought on the (marketplace), rather than debating whether Obamacare is good for the country.”