Lesa Evers, who’s 62, is logging onto her computer to shop for her health plan on the federal marketplace.
“We’re going to go in and update the application,” she says.
Evers retired from her job with the state health department nearly two years ago.
She has three more years until she qualifies for Medicare coverage. Insurance was top of mind when she was planning her retirement.
“It was like number one for me, because I can’t afford to be without it in the situation I’m at in Helena.”
Evers takes medication for high cholesterol. She needs a special breathing machine for her sleep apnea and takes insulin for her diabetes. She gets real-time readings on her phone through her blood glucose monitor.
“I needed a visual. If I had an orange, I could see how that impacted my blood sugar.”
That’s helped her keep her blood sugar in check after years of uncontrolled diabetes.
Evers enrolled in a marketplace plan after her state health coverage ended. With her tax credit of about $1,100, she pays nothing. That’s allowed her to live on about $3,700 a month from her state pension.
“I’ve still got to make a house payment, and electricity," Evers says. "My cars are paid off, but they’re aging.”
But premium assistance expires at the end of the year. Congressional Democrats say they won’t agree to end the federal government shutdown until Republicans agree to renew the tax credits. Republicans say Democrats need to open the government before tackling the issue.
Premiums in Montana are increasing between 11% and 29%, depending on the plan. Premiums rise every year, but some of the increase accounts for young, healthy people foregoing insurance if the tax credits expire.
Cynthia Cox is with KFF, a nonpartisan health policy research group.
“So if Congress extends these enhanced premium tax credits, then most people are not going to have a premium increase,” Cox says.
That’s because what people like Evers pay is based on their income. The federal government would pay more to cover rising premiums.
Evers’ tax credit would fully cover her nearly $1,200 monthly premium next year. It’ll be a tough pill to swallow if she has to come up with that money herself.
“That’s as much as my house payment, honestly," Evers says. "I’d have to make some changes and I’m on a pretty slim budget already.”
Evers would likely apply for her Social Security benefits early to afford her coverage. But that comes with a 30% penalty, meaning less income later in retirement.
“That’s a decision I have to make. If the tax credit goes away, I’ve got to find a way to pay. It’s not an option for me. I’ve got to find a way to pay.”
She hopes Congress will renew the tax credits until she’s able to enroll in Medicare.
