Montana to keep insurers; rates still unknown

Montana will retain its insurers in the Affordable Care Act’s marketplace for next year’s health coverage enrollment, but what those insurers’ rates will look like is still unknown.

This week, the Centers for Medicare and Medicaid Services released a look at the companies expected to remain in health exchanges for 2018. The speckled map shows the number of insurers in the market dropping. People based where insurers are bare will have fewer options for coverage through the federally-run exchange.

In contrast, Montana’s three major carriers — Blue Cross Blue Shield of Montana, PacificSource, and the Montana Health Co-Op — intend to stay, according to the state auditor’s office.

“Some markets are unstable. People have over-interpreted that to mean all are,” said Bryce Ward, director of health-care research at the University of Montana. “It’s certainly not the case in Montana.”

Last year, 52,473 Montanans used the marketplace offered through President Obama’s health law to gain coverage.

Ward said nationwide, insurance companies are deciding whether they’ll re-enlist in a market with an unknown future. The Trump administration has not yet said whether it will continue to make payments for the health law’s subsidies, which insurers receive to help cover low-income Americans in the exchanges.

Ward said removing those payments would destabilize the market and cause premiums to leap.

MONTANA has struggled with double-digit premium rate increases two years in a row.

The deadline for Montana insurers to file rates with the auditor’s office was June 8.

Kyle Schmauch, a spokesperson for the Montana State Auditor’s Office, said it will be a few months before the public knows what those requests look like.

“We’re just starting to dig into them,” he said.

Schmauch said matching previous years’ timelines, he expects the requests to be open for public comment in July. He said rates should be finalized by August.

The average pre-subsidy premium in Montana’s exchange in 2017 has been $581 a month, according to healthinsurance.org. That’s compared to the national average of $476 a month. But the majority of the 2017 enrollees — 84 percent — are receiving premium subsidies. Those subsidies bring the average premium to $176 a month.

Last month, the National Association of Insurance Commissioners announced that the unclear future of funding for cost-sharing reduction subsidies alone could increase premiums by roughly 20 percent, “or even more.”

In a letter to the state’s Commissioner of Securities and Insurance, Sen. Jon Tester, D-Mont., said the Trump administration was acting “irresponsibly” by leaving the funding in doubt.

“In the absence of that commitment, insurers face enormous uncertainty that is directly impacting their 2018 premiums,” he wrote in the letter.

In his written response to Tester, Rosendale said on Wednesday that he agreed the funding is vital for a stable market.

“The American health care system faced many serious challenges long before the ACA was passed, and Obamacare was riddled with so many critical flaws that it has created a whole new set of severe consequences for Montanans,” Rosendale said.

WHEN House Republicans narrowly passed their bill in May to replace the Affordable Care Act, they said that insurance markets were already failing. Many pointed to Iowa, where the last major insurer under the health law was threatening to pull out.

At the time, House Republican whip, Rep. Steve Scalise of Louisiana, told the New York Times there may be “nobody to write insurance for people that are in the Obamacare exchanges” in 94 of Iowa’s 99 counties.

The CMS map released this week will most likely change as issuers continue to make announcements on exiting or entering specific states and counties.

As is, the map shows that nationwide at least 35,000 active exchange participants will be without coverage on the exchanges for 2018. CMS also projected that roughly 40 percent of counties nationwide could have only one issuer in 2018.

CMS Administrator Seema Verma said the national image represents “another failing report card for the exchanges.”

As insurers continue to announce whether they intend to remain on the market, U.S. Senate Republicans are shaping their own version of health reform for the nation.

The office for Sen. Steve Daines, R-Mont., said he was unavailable for an interview. But in a video statement on Wednesday, the Republican senator said there’s “nothing affordable about Obamacare.”

“We need to replace Obamacare with a patient-centered health-care solution that is a real Montana-based solution,” Daines said. He did not describe steps to take for that solution.

Ward, with the University of Montana, said as 13 senators are drafting the bill in closed-door meetings, there’s still not a lot known about its possible impact — on insurance carriers or consumers.

“What [insurers] are asking right now is, ‘Can I get people to enroll at rates I need to charge in order for it to be stable?’” Ward said.

For some pockets throughout the nation, the answer has been no.

“Montana is not yet one of those places,” Ward said.

Reporter Katheryn Houghton may be reached at 758-4436 or by email at khoughton@dailyinterlake.com.