Few government-run health insurance programs can boast the kind of popularity Insure Montana enjoys. And despite the impending health insurance changes scheduled in the federal Patient Protection and Affordable Care Act, the need for this successful state program has not yet run out.
That fact was acknowledged last Thursday when a new funding plan for the program was announced last week. It’s a plan that, thankfully, preserves Insure Montana as an option for hundreds of businesses and thousands of employees.
Part of the reason Insure Montana is so popular is that it provides assistance to a critical group of Montana job-providers: small businesses. Despite its narrow focus, the program makes a big difference with limited dollars. Begun as a joint initiative by the governor and the state Commissioner of Securities and Insurance in 2005, Insure Montana’s public funding is provided exclusively through the Montana Tobacco Tax.
The program has two parts. One offers tax credits to employers who offer group health insurance to full-time employees, who must number no more than nine and no fewer than two. The other is a purchasing pool that allows small businesses to apply for subsidies and premium assistance.
Nearly 1,500 businesses covering roughly 8,000 Montana workers now participate in Insure Montana. Many more small-business owners would like to participate, and more than 300 are currently on a waiting list to do so.
Yet rather than supporting Insure Montana so it can meet demand, funding for the program has been reduced in recent years. The previous Legislature approved a bill that would have cut the number of participants receiving tax credits by 30 percent. Fortunately, this met with former Gov. Brian Schweitzer’s veto. Unfortunately, the 2011 Legislature’s move to reduce Insure Montana’s share of tobacco taxes did not meet with a similar fate, meaning the program was forced to reduce the amount of its subsidy payments in order to cover the same number of participants.
But that reduction pales in comparison to the original plan forwarded by Gov. Steve Bullock to phase out the program entirely. Bullock’s budget called for severely restricting eligible groups and then discontinuing Insure Montana by the end of 2014, ostensibly because federal health insurance programs would be available to replace it at that time.
However, Montana Commissioner for Securities and Exchange Monica Lindeen, whose office administers the program, has some sensible arguments to counter that assumption. She recently spelled them out for a legislative budget panel in a bid to keep Insure Montana alive at least until the next legislative session in 2015.
That, according to State Auditor Lindeen, would be a better time to take stock of the health coverage options available to small businesses in Montana. While the federal tax credit offered to small employers may be helpful, it may not be the best option. For some, it may not be an option at all; for instance, a large portion of Insure Montana participants – as many as one-third – may not be eligible for this credit because their only employees are family members.
Bullock’s office expects the expansion of Medicaid, as well as federal insurance exchanges and subsidies starting in 2014, to offer viable alternatives at a lower cost. But will they? How much lower will the cost be? What will coverage through these programs look like? How many businesses and individuals will actually choose them? The truth is, nobody knows for sure. Not yet, anyway.
And for many of Montana’s small businesses, this uncertainty is simply not something they want to gamble with. They shouldn’t be forced to. If federal alternatives do indeed prove preferable to Insure Montana, Insure Montana participants will willingly drop out of the program to take advantage of them. If not, they shouldn’t be forced out of a program that works, and works well.
The state spends about $10.5 million on Insure Montana each year. The program has managed to hold its administrative costs to a remarkably low 6 percent while negotiating remarkably low rate increases.
It’s proved itself to be not only visionary but effective, and for that reason it should continue to be offered to current participants – at least until viable alternatives have been tested and shown capable of covering any gaps. Without such evidence, any move to end Insure Montana would be a short-sighted one.
The new agreement to fund Insure Montana through the next two years has the support of Gov. Bullock and members of the Joint Appropriations Subcommittee on General Government. It ought to receive the full support of the Legislature, so that Insure Montana can continue to provide the certainty of a tested – and trusted – option for small businesses and their employees.
EDITORIAL BOARD: Publisher Jim McGowan, Editor Sherry Devlin, Opinion Editor Tyler Christensen