Over 100,000 Montanans lose their health insurance as the state’s Medicaid review proceeds

Helena, Montana – Over 100,000 Montanans have had their health coverage under the state Medicaid program terminated, according to revised data released this week. The state of Montana has been reviewing the eligibility of all Medicaid beneficiaries for seven months.

The Montana Department of Public Health and Human Services said on November 21 that 213,704 people had undergone the redetermination process. 104,097 of them, or around 48%, did not have their Medicaid or Healthy Montana Kids coverage renewed.

Of those whose coverage was canceled, 31,918 were found to be ineligible, and 65,897 did not submit the data that DPHHS needed to establish their eligibility.

DPHHS has been collaborating with Cover Montana, a program of the Montana Primary Care Association, from the beginning of the redetermination process to provide information to those who have lost coverage regarding their alternatives for obtaining health insurance. Using the individual health insurance marketplace created by the federal Affordable Care Act has been one of those choices. On November 1st, the marketplace opened for open enrollment.

“There are always Montanans who are uninsured, who really need to pay attention to open enrollment to make sure that they’re shopping around and taking the time to see what they qualify for,” said Olivia Riutta, director of Cover Montana. “This year, there are just more Montanans who need health insurance coverage.”

For the past ten years, Cover Montana has assisted individuals in enrolling in health insurance and notifying them of their eligibility. According to Riutta, the demand for these services has increased this year.

“It has by far been the busiest year that we have ever seen, since the first open enrollment period,” she said.

Last week, a report from the federal Centers for Medicare and Medicaid Services said 10,998 Montanans had signed up for health plans through HealthCare.gov since Nov. 1. That’s up from 10,030 over the same period in 2022.

It was not necessary for anyone who lost coverage as a result of Medicaid redeterminations to wait until open enrollment to enroll in a plan via HealthCare.gov. They are qualified for a special enrollment period that begins in the summer of 2024 and ends when their Medicaid or HMK expires. However, Riutta noted that because of the open enrollment period, it seems that a lot more people are now considering their health coverage.

According to John Doran, divisional vice president of external affairs for Blue Cross and Blue Shield of Montana, BCBS targeted Montanans who were no longer eligible for coverage due to Medicaid redeterminations with their marketing campaigns. According to him, marketplace enrollments increased steadily until the end of the summer, but in the fall, month-over-month growth slowed. According to Doran, a lot of the questions they received had to do with employment losses in addition to redetermination.

Leaders of Mountain Health Co-Op, which has members in Wyoming, Idaho, and Montana, have noted an increase in membership in each of the three states, which they believe is the result of individuals moving off of Medicaid. They said that a recent spike at the beginning of open enrollment is included in that.

Although the marketplace will be accessible for registration until January 15th, officials advise anyone interested in obtaining a plan to sign up by December 15th in order to begin receiving coverage on January 1st.

According to Riutta, the most frequent queries Cover Montana receives regarding market plans are concerning affordability, but the majority of individuals will be eligible for some kind of extra assistance. According to her, 87% of Montanans who sign up for a plan through HealthCare.gov receive tax credits that lower their monthly rates, and roughly 25% of them receive plans with lower out-of-pocket expenses.

“We want to make sure that if folks need coverage if they’re not sure, to reach out and make sure they’re having a conversation with someone to see if they, in fact, should take the time to apply,” said Riutta.

Visit the Cover Montana website for additional information if you want help with the enrollment process or if you have concerns about your options for coverage. Their Help Line can be reached at (844) 682-6837.