Confused by the Affordable Care Act?

December 15, 2014

Posted By: Shaunescy


I grew up in Germany with government-subsidized healthcare. My single mom often worked two jobs to take care of my brother and me, but when we were sick, we went to the doctor. What seemed normal to me is not the reality for many Montana parents. As a parent myself now, making sure my children are adequately covered has been more of a headache than it should be.

Regardless of your political opinions on the Affordable Care Act (ACA), it is here now and we all must navigate the sometimes-confusing landscape of the marketplace, eligibility criteria, tax credits and more. Just thinking about it makes me yawn.

Since my kids are on Medicaid (or Healthy Montana Kids Plus as it is now called), I did not have to find new insurance for them. Montana is one of the states that refused to accept the federal subsidy to expand Medicaid. What I’m saying is, your kids could’ve been covered like mine, but our state legislators decided to send Montana taxpayer dollars out of state instead. If you’d like to argue that the money would be better spent on reducing the deficit...well, unfortunately it isn’t going there.

It’s going to other states that have expanded Medicaid.

What if Montana had accepted the Medicaid expansion?

Had Montana accepted the Medicaid expansion, a family of four with an annual income ranging from $32,913 - $95,400 would be eligible for a premium tax credit, the subsidy that makes monthly premiums so affordable. Almost everyone making less than that would be covered by Medicaid, because of the broader eligibility parameters under the expansion.

What is the effect of Montana being a non-expansion state? Since Montana didn’t expand Medicaid, premium tax credit eligibility for a family of four starts at $23,850 yearly. Sounds good, right? More people will get the tax credit. Not necessarily. Many people who make less than this, and therefore aren’t eligible for the tax credit, won’t be eligible for Medicaid either because we refused the expansion, leaving them without affordable insurance options. The Kaiser Family Foundation estimates that 40,000 uninsured adults in Montana will fall into this coverage gap. Because of this, many individuals and families will continue to delay medical care until they absolutely can’t wait anymore.

What if I fall into the non-expansion gap?

Bridgercare offers reproductive health services on a sliding fee scale to help everyone access the medical care they need. In addition, Certified Application Counselors will provide information about insurance options and credits through the ACA marketplace and help you with your application – for free.

If you aren’t eligible for discounted ACA coverage, Bridgercare can help you access programs like Plan First, United Way and the Montana Cancer Control Program that provide specific low- or no-cost healthcare services.

Is this really worth my time?

Eighty six percent of Montanans who signed up during initial enrollment qualified for financial help. The average Montanan is paying $99 a month for coverage – less than your average cable bill. Help with your healthcare application is absolutely free.

Open enrollment started November 15, 2014 and runs through January 15, 2015 and Bridgercare is scheduling appointments now. Please call 406-587-0681.


Juliane McLean is the Development Coordinator at Bridgercare, a mother to four daughters, and an advocate for accessible healthcare regardless of income. Bridgercare

provides excellent, affordable reproductive and sexual healthcare and education in a safe, supportive, empowering atmosphere. Please visit to find out more.

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