Susan Higginbotham had some good news to deliver this week to some of the people she’s helped obtain health insurance through the federal Health Insurance Marketplace.
“I’ve been able to show them they could get a reduction in their rates,” Higginbotham said. “Some people were able to get the silver plan with no premium at all where that wasn’t possible before.”
Higginbotham is Ravalli County’s only Marketplace navigator not associated with a health insurance company. She has an office at Hamilton’s Sapphire Community Health.
New premium subsidies for Affordable Care Act health plans are part of the $1.9 trillion relief package signed by President Joe Biden in early March. The new plans became available on April 1.
Most people who currently have a Marketplace health plan will see lower monthly premiums and those without insurance may now be able to afford to buy it, Higginbotham said. People already enrolled will have to re-enroll to take advantage of the changes.
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“People will have to go back in and redo their plans through Marketplace,” she said. “They are saying that four out of five customers can expect to get plans that cost less.”
The special enrollment period will be open through Aug. 15 on HealthCare.gov.
Nationally, the American Rescue Plan made 3.7 million more people eligible for premium subsidies under the ACA, according to Kaiser Family Foundation. Before the federal relief package, people making more than 400% of the federal poverty level — about $51,500 for an individual or $106,000 for a family of four — didn’t qualify for federal assistance. The cap was lifted so no one would pay more than 8.5% of their income toward health insurance.
The new provisions last two years.
Jeremy Smith, program director of MT Navigator — a nonprofit enrollment assistance group — said the extended enrollment period, along with the lower prices and expanded eligibility, is the most significant thing to happen to health care in Montana since the rollout of the ACA.
“Thousands of residents have gained health coverage since the rollout of the ACA back in 2013, but we know that coverage was still out of reach for a lot of families,” Smith said. “These expanded subsidies will make coverage more affordable right away for almost everyone who wants Marketplace enrollment.”
On average, MT Navigator said premiums will decrease by $50 per person per month or by $85 per monthly policy. Four out of five enrollees will find a monthly plan for $10 or less after premium tax credits.
In the past, Higginbotham said she’s worked with people who were challenged to find a plan they could afford. They either made too much to qualify for Medicaid or weren’t able to get enough tax credits to make the purchase of a plan realistic.
“There are quite a few people in the county without any health insurance,” she said. “They are saying that this will save the average person $50 a month. That absolutely makes a big difference, especially if you are living from paycheck to paycheck.”
People interested in making an appointment with Higginbotham to learn more about the expanded program can call Sapphire Community Health at 1-406-541-0032.
“It goes faster if people come prepared,” she said. “I can roll through a marketplace application in about 45 minutes for most people.”
MT Navigator is also available to assist people with the process of signing up and applying for subsidies. Anyone in Montana can call 406-430-0005 to get free enrollment assistance. Consultations are available over the telephone or through a telehealth option, allowing callers to see their application completed in real-time.
More information is available at acanavigator.com.
There is no charge for enrollment assistance.