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Affordable Care Act Enrollment Begins website, 11/2/18 website, 11/2/18

The Affordable Care Act’s sixth sign-up season is now underway.

The roughly 62,000 Montanans who buy their own health insurance have until December 15 to shop for a policy. And, for the first time they can also choose to skip out altogether on ‘Obamacare’ without fear of incurring a tax penalty.

The Montana Primary Care Association’s Olivia Riutta, however, cautions Montanans to think carefully before going that route.

“We all think we’re healthy today, and we might be, but we’re heading into winter in Montana,” she says. “You walk down the sidewalk, and anything can happen. That health insurance is super important for peace-of-mind, for unexpected injury or illness that happens to everybody at some point.”

Congress last year scrapped the ACA’s tax penalty for those who choose to go without health coverage.

The penalty’s removal starts with 2019 tax returns filed in 2020.

Some say that will also tempt people to consider buying a short-term policy:

“You’ll hear them referred to as ‘junk plans,’” Riutta says. “I like to call them ‘swiss cheese plans’ because there’s a lot of holes in them.”

Riutta points out that all standard ACA plans cover the widest variety of healthcare providers and services

“Whether you're gonna need to land in the emergency room, in-patient, out-patient, primary care, prescription drugs, behavioral health services, maternity coverage – they cover it all.”

Short-term policies are different. They cover a patchwork of services, but do not offer all the protections of an ACA policy.

“[They] sound really great but it’s not a great deal when you need the plan to cover something and it simply doesn’t cover that part of the health care that you need,” Riutta says. “The other thing we’re going to see with these ‘swiss cheese’ plans is folks are going to be able to be charged more because of their age, their health status. When you apply to there are no health questions other than your tobacco use.”

Three health insurance companies offer ACA plans in Montana: Pacific Source, Blue Cross/Blue Shield of Montana and the Montana Health Co-op.

“We have seen premium increases,” Riutta says. “The good news is for those 87 percent of Montanans who enroll through the marketplace and receive tax credits, the way that the tax credits are calculated means that most folks are protected from premium increases because their tax credit will actually increase to meet that rising premium cost.”

Montana received no federal money this year for nonprofits to hire so-called ‘navigators’ who help people enroll in ACA plans.

No navigators in a big, rural state like Montana means there are fewer people available to connect consumers to healthcare coverage.

Olivia Riutta, however, points out there are still counselors out there ready to help steer Montanans through the sometimes complicated process of buying insurance:

“Folks know the word ‘navigator’ more than they know ‘Certified Application Counselor,’” Riutta says. “The good news is we continue to have folks who are able to sit down and provide direct enrollment assistance. There’s no charge. Their services are confidential, and they’re trained and certified in doing this work. We continue to see a strong network of folks across the state who’ll do that for Montanans who need that little bit of extra help.”

Riutta advises those who intend on purchasing a health plan under the Affordable Care Act to not procrastinate.

“Because there are folks across the state who can help walk you through that application process, but they’re going to get busy the closer we get to December 15,” she says. “Take the time to start that process early so you do not run out of time, and if you need any help you can get in and see somebody.”

Olivia Riutta is outreach and engagement manager for the Montana Primary Care Association, which represents community health centers that mostly serve low income Montanans.

Edward O’Brien first landed at Montana Public Radio three decades ago as a news intern while attending the UM School of Journalism. He covers a wide range of stories from around the state.  
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