Television ads supporting Republican Senate nominee Matt Rosendale blame U.S. Sen. Jon Tester for increased health insurance rates. Ads backing Tester say Rosendale let rates go up for Montanans. Neither side is correct.
In a recent guest opinion published in the Billings Gazette, Rosendale wrote: “I will never stop fighting to expand access and bring more affordable health care to Montana families and small businesses, and I will always protect those Montanans with preexisting conditions.”
As the state’s insurance commissioner, Rosendale should know that the policies he supports do the opposite of what he promised. He opposed the access to affordable care the HELP Act is providing to 100,000 Montanans. He promotes the short-term policies that can reject Montanans who have pre-existing health conditions. A study based on 2015 data estimated that 25 percent of Montanans ages 18-64 have pre-existing conditions that could disqualify them from policies not subject to Affordable Care Act requirements.
Rosendale’s “repeal Obamacare” mantra rings hollow. Montanans have benefitted from the Affordable Care Act, Despite its flaws, the ACA has given many thousands of Montanans the peace of mind that a medical emergency won’t trigger financial disaster.
As a state senator in 2015, Rosendale voted against the HELP act that expanded Montana Medicaid to all very low-income adults, regardless of age. Now about 100,000 Montanans have coverage through HELP, including people who previously were uninsured and people whose health care had been funded through 100 percent state general fund programs.
The HELP act took effect on Jan. 1, 2016, and since then has saved state money that previously would have been spent on mental health care, addiction treatment and inmate medical care.
Medicaid covers the bulk of addiction treatment in Montana, making the program crucial for addressing the epidemics of meth and opioid abuse afflicting our communities.
Without the HELP Act, Montana hospitals would see more patients who couldn’t pay for their care, shifting the costs to those who are still insured.
In the 2013 Legislature, Rosendale voted against legislation to authorize the state insurance commissioner to review rates that health insurers propose to charge Montanans. That bill, sponsored by a Republican, became law despite Rosendale’s opposition and now gives him authority to hold health insurers accountable.
The law doesn’t allow the commissioner to set rates, but it does require insurers to report their planned rates for the individual and small group markets and requires an actuarial analysis of those rates.
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If Rosendale determined that the proposed rates weren’t justified by the costs of providing care, he could negotiate with the insurers and use the bully pulpit of his state office to pressure insurers to stop overpricing.
Rosendale hasn’t done that. Instead, he found that the rates proposed were justified.
Rosendale claims that he will protect Montanans with pre-existing conditions. But he has championed so-called “short-term” plans that allow insurers to refuse coverage to people with pre-existing conditions.
The federal government recently released rules that will allow short-term plans to be sold for terms of up to a year and to be renewed for three years. However, the insurer can choose not to renew.
In April, the Kaiser Family Foundation reported that 43 percent of the short-term plans it analyzed in 45 states don’t cover mental health services, 62 percent don’t cover substance abuse treatment, 71 percent don’t cover outpatient prescription drugs and none covers maternity care.
In Montana, according to the Kaiser analysis, none of the four short-term plans available provided any of those benefits.
Short-term plans can also refuse coverage of pre-existing conditions, put dollar limits on what they will cover and set higher deductibles than are allowed under plans that comply with the ACA, according to the Kaiser analysis.
Short-term plans’ selling point is lower premiums — not good value. Among the ACA’s consumer protections is a requirement that limits what insurers can charge for overhead. If the plan pays out less than 80 percent of premiums collected, the insurer has to refund the difference to customers. Short-term plans have no such requirement.
According to National Public Radio, the National Association of Insurance Commissioners reports that short-term policies paid out an average of 55 percent of their premiums on health care or refunds to customers.
Health insurance is complicated. The more Montanans know, the more we realize that sound bites and political ads may be hazardous to our health