The Affordable Care Act One Year Later - KFBB.com News, Sports and Weather

The Affordable Care Act One Year Later

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Does Montana need more primary care physicians? Local medical professionals think so.

36,000 Montanans gained health insurance this year through the Affordable Care Act, and more people insured means more patients and appointments -- so it's a very busy time for family care doctors, according to Riverstone Health President & CEO John Felton.

"In a community like Billings, we have more providers, but despite that, all the family care providers are extraordinarily busy," he said. "There's just lots and lots of people that need to be seen."

A physician's foundation study reports 80 percent of primary care doctors in the United States feel they're at full capacity.

Dr. Bradley Fuller at Fuller Family Medicine says he's seen a big increase in new patients this year, but he says, although more Montanans are insured, many people are still not seeking care because of high deductibles and high out-of-pocket costs.

"Even though it used to be a $25 co-pay until they hit their deductible, which are now in the thousands, they're just paying out of pocket for routine physician appointments," he said. "So, yes, more people are insured, but unfortunately a lot of people aren't able to use (their insurance), because deductibles are so high."

While deductibles and out-of-pocket costs vary from plan-to-plan, premium increases vary state-to-state.

The office of Montana Commissioner of Securities and Insurance Monica Lindeen reports Montana premiums will increase -- on average -- about 1.3 percent. Some plans will have lower premiums, while others may increase by more than seven percent.

1.3 percent is a lower increase than the year-to-year increases of individual plans over the past five years. According to Lindeen's office, the state's individual market premiums have increased at least 13 percent since 2009.

Some states will have increases of more than 10 percent, but Felton says Montana's 2015 increase is low because -- historically -- Montanans don't overuse insurance. He also says the ACA law is comprehensive and some elements are often forgotten.

"The pieces that people really like -- things like kids being able to stay on their parents plans until they're 26, not being able to deny people coverage for pre-existing conditions -- those sorts of elements are very, very popular across the political and social spectrum," Felton said.

The open enrollment period lasts until December 15. If you sign up after that date, your plan will not go into effect until at least February 1, 2015.
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