Report: 142,000 Montanans could lose health insurance if Congress repeals ACA

By Martin Kidston/Missoula Current

As many as 142,000 Montanans could lose their health insurance if Congress and the incoming Trump administration make good on their promise to repeal the Affordable Care Act, according to a report released this week.

The Montana Budget and Policy Center said that under the ACA, the state’s rate of uninsured dropped from 20 percent in 2012 to just 7.4 percent in 2016. As many as 195,000 Montanans were uninsured before the ACA was implemented, though that now stands at just 85,000.

Heather O’Loughlin with the Budget and Policy Center said coverage for many Montanans could end if Congress repeals the ACA.

“Should Congress move forward with a repeal with without simultaneously including a replacement, it could put at risk the health care coverage of over 142,000 Montanans who have benefited from ACA,” O’Laughlin said. “The most significant portion of those losing coverage are those who have benefited from Montana expanding Medicaid.”

The Health and Economic Livelihood Partnership Act, adopted by the Montana Legislature in 2015, allowed the state to use federal funding to provide health care coverage to adults with incomes of less than 138 percent of the federal poverty level.

Of the state’s newly insured, 61,000 who gained health care through Medicaid expansion are at the greatest risk of losing coverage if Republican’s succeed in repealing the ACA, the report says. Dismantling Medicaid expansion, the report adds, runs contrary to the desire of the state to expand access to health care.

“Under what we understand of what President-elect Trump and Congress want to move forward with is that it’s a partial repeal with no replacement, and that would likely mean the end of Medicaid expansion and the loss of coverage for those 61,000 Montanans,” O’Loughlin said.

O’Laughlin said a repeal could also impact Montana’s health care providers, many who serve at small, rural hospitals and clinics. Medicaid expansion was a benefit to providers, she said, because it reduced the level of uncompensated care.

“We could see uncompensated care costs increase more than two-fold by 2019 as a result of an ACA repeal,” O’Laughlin said. “What does this mean for rural communities, rural hospitals and providers across the state, as far as covering health costs if that uninsured number increases so significantly?”

A repeal would also result in 8,000 Native Americans losing coverage, the report notes.

“Montanans deserve to know what their health care coverage will look like moving forward,” O’Laughlin said. “Repealing the ACA without putting in place a replacement puts at risk the health care coverage of thousands of Montanans.”

Contact reporter Martin Kidston at info@missoulacurrent.com