Briana Wipf

bwipf@greatfallstribune.com

A year after the opening of the health insurance marketplace, insured rates are already changing in Montana.

Before the health insurance marketplace, about 20 percent of Montanans were uninsured, according to a 2012 report prepared by the Bureau of Business and Economic Research.

After one year of insurance mandates under the Affordable Care Act, that percentage has dropped to 16.9 percent, said Monica Lindeen, Montana’s commissioner of securities and insurance.

“So (the marketplace) has put a dent in that,” Lindeen said.

In raw numbers, 36,584 Montana residents selected marketplace plans, of the 55,675 who were eligible, according to data current as of April 19, 2014, from the Kaiser Family Foundation.

According to Kaiser data, of those eligible to enroll, 39,572 were eligible to enroll in the marketplace with financial assistance.

Those who make between 138 and 400 percent of the poverty level are eligible for tax credits if they purchase insurance on the marketplace.

Another 4,638 residents were determined to be eligible for Medicaid or CHIP when they attempted to enroll in the marketplace, according to Kaiser.

People still can purchase insurance policies directly from insurance providers, but they won’t receive tax credits if they do so.

The 2012 BBER report estimated the number of uninsured people in Montana at about 195,000 before implementation of the ACA.

One challenge that has cropped up in the first year of the marketplace is helping the newly insured understand what health insurance can do for them, said Gloria Baca, of the Centers for Medicare and Medicaid Services.

Some people have insurance for the first time in their lives and may not know how to choose a primary care provider, when to go to the doctor and what concepts like co-pays, coinsurance and premiums are.

“Now that they’ve got insurance, they need to figure out how to use it,” Lindeen said.

Baca said CMS has prepared literature for newly insured people to help them navigate the health care system.

She added it isn’t unusual for people who are newly qualified for Medicare coverage but have ever had insurance before also face those same difficulties.

Of the people still uninsured in Montana, some would become covered by Medicaid if the state decides to expand that program.

Estimates of the number of people who would qualify for expansion vary, from 50,000 according to Lindeen’s office to 70,000, an oft-cited number that comes from that 2012 BBER report.