Contact Us

Affordable Care Act Loopholes May Hurt Montanans

Doc's office
Photo courtesy of Cult Gigolo/Flickr

The federal health exchanges in Montana open up on October 1. The new exchanges will force many businesses to decide what type of health insurance to provide for their employees, or if they will continue to provide any health insurance at all.

One of Montana’s certified healthcare navigators, Mary Angela Collins with Montana Health Insurance Experts LLC, said there are certain loopholes that business owners and employees need to be aware of.

“Well, one of the things to watch out for is, if a person is offered affordable insurance – and the definition of affordable is that the coverage just for the employee costs less than 9.5 percent of their income – then, they are not eligible for subsidies on the exchange,” Collins said.

The loophole is larger than it may first appear because it could effect dependents of an employee as well. The Affordable Care Act does not consider the ‘affordable’ nature of the costs of dependents. Only the primary holder of the insurance must have costs below 9.5 percent. If a business offers insurance coverage for an individual that is below 9.5 percent, even if coverage for dependents is significantly more expensive, it means that both the individual and any dependents will be refused subsidies on the healthcare exchanges.

“It could be that it’s better to offer [health insurance] just to your employee and not to the family, so that the family can qualify for subsidies later if the family coverage is too expensive,” Collins said. “So that’s just something for employers to calculate. Is it better to offer insurance just to my employees, or to my employees and their dependents and spouses?”

Another big loophole for Montana revolves around the fact that the state did not expand Medicaid. Those that are under 100 percent of the poverty level, but make too much to get Medicaid coverage will also not qualify for subsidies at the exchanges.

Mary Angela Collins:

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

Best of News Talk KGVO

Recommended for You

Best of the Web

Leave a Comment

It appears that you already have an account created within our VIP network of sites on . To keep your personal information safe, we need to verify that it's really you. To activate your account, please confirm your password. When you have confirmed your password, you will be able to log in through Facebook on both sites.

Forgot your password?

*Please note that your prizes and activities will not be shared between programs within our VIP network.

It appears that you already have an account on this site associated with . To connect your existing account just click on the account activation button below. You will maintain your existing VIP profile. After you do this, you will be able to always log in to using your original account information.

*Please note that your prizes and activities will not be shared between programs within our VIP network.

Please fill out the information below to help us provide you a better experience.

(Forgot your password?)

Not a member? Sign up here

Sign up for KGVO Club VIP quickly by connecting your Facebook account. It's just as secure and no password to remember!

Sign up to have exclusive KGVO Club VIP contests, events, coupons, presales, and much more delivered to you for FREE.