The number of Montanans enrolled in federally subsidized health insurance plans over the past four years increased by about 50%, or about 22,000 people. That’s according to KFF, a nonpartisan health policy research group.
The growth is attributed to enhanced subsidies during the pandemic. But those are set to expire at the end of next year. This fall’s election could impact whether they’re renewed.
The Affordable Care Act created a federal health insurance marketplace. Under the program federal subsidies pay a portion of people’s premiums based on income.
To keep people insured during the pandemic, Congress boosted that assistance significantly. That helped low-income people get premiums as low as $0. It also allowed people with higher incomes to benefit.
Olivia Riutta leads Cover Montana, which helps people shop for marketplace plans. She says these subsidies have been a big help for people kicked off Medicaid as the state reassessed its rolls for the first time in years.
"The enhanced affordability provisions have been really helpful for them to make sure they can afford to pay that monthly premium,” Riutta said.
If enhanced marketplace subsidies expire next year, Montanans could pay up to $90 more every month for their insurance, according to a KFF analysis. That’s hard to absorb for low-income people, says Adrianna McIntyre, professor of health policy and politics at Harvard.
“It could be the difference between a tank of gas and your health insurance, a grocery run and your health insurance, and I think that’s really at stake here,” McIntyre said.
McIntyre thinks the most realistic way subsidies get renewed is if Democrats maintain control of Congress and the White House.
University of California Irvine Health Policy professor Dylan Roby says even though Republicans didn’t vote for the subsidies, he thinks that could change.
“You might see a few conservative house or senate members, who might say we can’t make everyone’s premiums go up the year we were all elected to office,” Roby said.
He says if the subsidies were to expire the largest premium increases would be in deep red states like Montana. He says that may ramp up pressure to keep them in place.
