This month marks a decade of Montana's Health Insurance Marketplace and Before the Affordable Care Act, one in every five Montanans was uninsured and lived with uncertainty and lack of access to health care. So, on this 10th anniversary of the Marketplace, we are celebrating ten milestones of the past decade.

#10: Remember when crashed? Don't worry, it works now!

At Cover Montana, we have been around since the beginning and remember that first Open Enrollment period when the website crashed. The website has come a long way, and we are happy to report that it works well! With just one application, you can enroll in a Marketplace plan, Healthy Montana Kids, or Montana Medicaid.

#9: Bye-bye pre-existing condition exclusions

The ACA eliminated pre-existing condition exclusions - a Godsend to Montanans with conditions like asthma, diabetes, or being a cancer survivor. And to make it even better, these protections extend to non-Marketplace plans too.

#8: Medicaid expansion!

Since Montana expanded Medicaid in 2016, Medicaid has been an affordable, comprehensive health insurance coverage option for 100,000 Montanans. During the pandemic, Medicaid did its job and made sure that the thousands of folks who lost jobs and faced reduced hours had access to care.

#7: No-cost preventive services

With the ACA came no-cost preventive service. Now, insurance will pay the full price for certain screenings and preventive measures such as annual exams for women, immunizations, and screenings for things like colorectal cancer. 

#6: Marketplace enrollment tops 51,000 in 2022

January 15th closed the last Open Enrollment Period, and Montana had more than 51,000 enrolled in coverage. This is a 14% increase over last year. 

#5: Marketplace plans are more affordable than ever (really)!

The American Rescue Plan Act (ARPA), the big COVID legislation from 2021, made Marketplace plans even more affordable and lifted the cap on who may qualify for tax credits. The annual savings is more than $800 per individual enrolled in a Marketplace plan. 

#4: New Special Enrollment Period for those below 150% of poverty

This new special enrollment period allows folks to enroll outside of the annual Open Enrollment Period if they are at or below 150% of the Federal Poverty Level. Now, a single person who makes $19,320 a year or a family of three making $32,940 can still get covered. 

#3: Special provisions for enrolled tribal members 

The ACA included several special conditions for enrolled members of a federally recognized tribal nation. First, enrolled members can get covered throughout the year, not just during open enrollment. Zero cost-sharing and limited cost-sharing plans are also available, making access to care much more affordable.  

#2: Plans cover essential health benefits

All Marketplace plans, and most non-Marketplace plans, must cover the 10 essential health benefits. These include everything from emergency services, maternity coverage, prescription drugs, mental health, and more.

#1: Uninsured rate cut in half

Before the ACA, one in five Montanans didn't have health insurance. Now that rate is one in 10.   

Montana has a lot to be proud of, from big wins like cutting the uninsured rate in half to helping more than 5,500 folks on Medicaid get inpatient treatment for a substance use disorder. But there is a lot of work ahead. In Montana kids, 6.2% are still uninsured and we will keep working in communities across the state to make sure that all our neighbors have the information and support they need to get covered. It's been an incredible decade, and Cover Montana has been a proud partner.

Olivia Riutta is the Director of Population Health at the Montana Primary Care Association and leads Cover Montana, a statewide program to get Montanans enrolled in insurance coverage.