The ongoing COVID-19 pandemic has impacted millions across the country, and Montana has not been spared. After the pandemic ravaged the state, President Biden’s executive order to re-open the federal health care exchange allowed approximately 80% of Montanans to receive help paying their premiums and access testing and treatment for COVID-19.
Even before the pandemic, research showed that more than half of Americans with employer-sponsored health insurance had delayed or postponed recommended treatment for themselves or a family member in 2020 due to cost. Now, as insurers continue to make billions while rolling back services like COVID-19 coverage, it has never been more crucial for Montanans to take the time and examine what different health plans do and do not cover. Health insurance practices are changing, and Montanans need to be prepared.
With Open Enrollment beginning November 1 for many Montanans, it is vital that consumers be aware of the potential pitfalls that exist, including changes to COVID-19 coverage, surprise medical bills and junk health plans that fail to cover pre-existing conditions. October marks Health Literacy Month, and Consumers for Quality Care (CQC) is helping Americans to understand their options for selecting health insurance coverage and making sure they know the details of the health care plans they are selecting.
Already, insurance companies are changing their policies when it comes to COVID-19. Nearly three-quarters of the largest health plans across the country are ending their COVID-19 cost-sharing waivers, a move that will only harm patients. Health care costs are continuing to rise for Montanans, and CQC research has shown that Montanans overwhelmingly favor policies to lower deductibles and prevent insurance companies from selling junk plans and requiring pre-authorization for life-threatening diseases.
Consumers should not have to deal with crushing medical debt, especially during a pandemic that has caused unprecedented job loss and income reduction. It has never been more important to weigh the options and take considerable care when choosing a health plan.
Telehealth has become a lifeline for many Americans during COVID-19, including those in Montana, where the rural makeup of the state often presents a barrier in access to care as many need to drive miles away to the nearest provider. According to a report from KPAX-TV, telehealth options remain extremely important to Montanans, and studies show they will continue to use the service even after the pandemic.
Unfortunately, some insurers are already rolling back coverage for this essential tool, which has proven to have profound benefits even beyond the pandemic, particularly in rural and underserved communities who often lack easy access to health care services. When selecting a health plan, consumers should understand how services like telehealth will be covered, and if they will be covered at all.
Surprise medical bills continue to be a major problem for Montanans. According to CQC research, over 70 percent of Montanans strongly agree that insurance companies should not be allowed to sell plans that cover so little that going to the doctor isn’t affordable. Even when they do their due diligence, consumers are still getting stuck with large, unexpected bills.
Legislation passed by the U.S. Congress last year will protect many Americans from surprise billing starting next year, but details of the law are still being developed. With many uninformed or in the dark about this ongoing legislative battle, consumers should always check if a provider is in-network and closely examine all medical bills before paying them.
With an estimated one-third of COVID-19 survivors identifying as having lasting effects from the virus, consumers in Montana must be wary of junk health plans like short-term limited-duration insurance plans (STLDIs) that often exclude coverage of pre-existing conditions. Montanans looking to save on health care costs should avoid STLDIs, which entice consumers with lower premiums but often leave them without adequate coverage when they need it most.
With a heavy reliance on telehealth services due to Montana’s rural makeup and a fear of predatory insurers peddling junk plans with high deductibles, now more than ever, lawmakers, state insurance commissioners, insurers and hospitals need to address rising health care costs and ensure all Americans can access the quality, affordable care they need and deserve.
In the meantime, CQC urges Montanans to carefully examine their health insurance options during 2021’s Open Enrollment so they can make the best possible decision for themselves and their families.
Donna M. Christensen served nine terms in the U.S. House of Representatives and was the first female physician elected to serve as a House member. She now serves on the board of directors of Consumers for Quality Care.