HELENA — Big changes are coming for the nearly 30,000 Montanans who get their health insurance through the state employee health plan. Last week, plan members received word from the Montana Department of Administration that, starting next year, they will have to pay more of the cost for their care.
“Almost immediately upon members receiving that, we started getting phone calls, text messages and emails,” said Melissa Romano, president of the Montana Federation of Public Employees, the union that represents many of the members.
(Watch the video for more on what's changing for plan members.)
Romano said the state’s announcement came as a surprise to MFPE.
“Our members are living paycheck to paycheck,” she said. “They're going to have to make hard choices about whether they're paying for groceries, gas, their rent or their mortgage, or whether or not or not they're going to head to the doctor.”
The biggest changes for the plan will be in medical deductibles – the amount a member must pay in a year before the plan begins providing coverage. Starting in 2027, deductibles will triple, from $1,000 per individual to $3,000 per individual. The maximum out-of-pocket costs will double, from $4,000 to $8,000 for an individual and $8,000 to $16,000 for a family. Full-time employees will also need to pay another $60 in monthly contributions – and for those with family members enrolled, the increased contributions will be $100 a month.
You can find the Department of Administration’s full explanation of the changes on their website.
Amy Jenks, administrator of DOA’s Health Care and Benefits Division, says leaders understood plan members were concerned about the changes.
“We looked at many alternatives,” she said. “This was the most feasible option for the state of Montana and the taxpayer dollars as well as the employees.”
Jenks said the changes are necessary to keep the health plan financially stable. The state negotiates the plan with MFPE every two years before the Montana Legislature’s session, and the most recent bargain included a provision that let the state make changes to contributions if they determined the plan’s reserves fell too low.
Jenks said the basic structure of contributions to the plan has not changed since 2016, but the health insurance market has. She said the number of people covered hasn’t gone up significantly, but costs are rising because members are simply making more and larger medical claims than in the past. She said there is a growing number of people on the plan who need $1 million or more in care in a single year.
One particular issue Jenks pointed to is the cost for prescription medication.
“Now we're getting hit with a lot of members utilizing GLP-1s,” she said. “There are just new therapies out on the market that are more expensive than ever – cancer therapies are extremely expensive.”
Romano said MFPE is disappointed the state announced these changes now – just before the start of their upcoming collective bargaining with their union, set to begin on Thursday.
“We understand that prices are going up and we need more money into the health care plan, but we also reject the notion that that should fall on the backs of public employees,” she said.
Jenks said the state will also propose increasing their share of funding for the health plan by 5%, or about $8 million. That will require state lawmakers’ approval during next year’s legislative session.
“If we do not get that 5%, that will be an additional hit to the employees, that would have to make further benefit adjustments,” said Jenks.
