Over the past four years, the number of Montanans with federally subsidized health insurance has increased by about 50%, or about 22,000 people, according to KFF, a nonpartisan health policy research group.
The growth is thanks to subsidies beefed up during the pandemic, but they are due to expire at the end of next year and elections this fall could influence whether the subsidies are renewed.
The Affordable Care Act created the federal health insurance marketplace, a program where federal subsidies pay a portion of your premiums based on your income.
To keep people insured during the pandemic, Congress has significantly increased aid, lowering premiums to as low as zero for low-income people and extending benefits to higher-income people as well.
Olivia Liutta, who runs Cover Montana, a group that helps people choose Marketplace plans, said the subsidies have been a big help to people who were kicked off Medicaid as the state reevaluated its enrollment list for the first time in years.
“The ability-to-pay provisions have been extremely helpful in making sure they can pay their monthly premiums,” Liutta said.
A KFF analysis found that Montanans could end up paying up to $90 more per month in premiums when enhanced market subsidies expire next year — a “heavy burden for low-income people,” said Adriana McIntyre, a professor of health policy and political science at Harvard University.
“It could be the difference between a tank of gas and health insurance, grocery shopping and health insurance, and I think that's what's really causing the problem,” McIntyre said.
McIntyre believes the most likely way for the subsidies to be renewed is if Democrats maintain control of Congress and the White House.
Dylan Roby, a health policy professor at the University of California, Irvine, said he thinks that could change even if Republicans don't vote for the subsidies.
“There may be some conservative members of the House and Senate who say we can't raise everyone's premiums in the year we're all elected,” Roby said.
He said the biggest premium increases would be in heavily Republican states like Montana if the subsidies expire, which could increase pressure to keep the subsidies in place.
