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When a former ski resort employee called her Bozeman pharmacy to refill her birth control, she found out the prescription would cost $85 a month after she was laid off and lost her work-based health insurance.

Stephanie McDowell, the executive director of Bridgercare, said that patient was able to get birth control through the nonprofit, which offers reproductive health care on a sliding fee scale.

McDowell said the need for that financial aid is going up after thousands of Montanans lost work last month as businesses closed in the state’s attempt to slow the spread of the novel coronavirus.

“Usually our patients who need to access our sliding fee scale are the working poor. They have insurance but can’t make ends meet on their salaries,” McDowell said. “But right now we’re seeing patients come in who have lost everything, their income and their insurance.”

In four weeks, Bridgercare spent roughly $100,000 toward services patients couldn’t pay for. That’s typically the amount of uncompensated care the clinic accumulates over three months.

“I know there are a lot more people out there who don’t have insurance right now who are just waiting, hoping nothing happens,” McDowell said. “That’s my biggest concern. What you don’t need right now is an unintended pregnancy on top of all of this.”

The Montana Healthcare Foundation released the most recent picture of the state’s health insurance landscape, which estimated 8.6% of Montanans were uninsured in 2019 — roughly 94,000 people.

State officials have said with the more than 70,000 unemployment insurance claims filed since COVID-19 reached Montana, it’s likely many people also lost their employer-provided health insurance. Those work-based plans are the biggest business in Montana’s marketplace insurance.

No one knows how many people are uninsured as a result of the crisis. The state doesn’t regulate private insurance and doesn’t track enrollment data.


State officials and health providers are watching Medicaid enrollment numbers, which will be one of the earliest indicators of the pandemic’s impact on health insurance.

Montana is also one of the states that expanded its Medicaid program to include the working poor, which health providers have said will likely help as some people filing for unemployment in Montana had hours reduced.

McDowell said Bridgercare is helping people enroll in Medicaid through the clinic’s certified counselors who can do the process in-house. But she said government subsidies won’t cover everyone.

A recent analysis by think tank Urban Institute estimated 60% of the 23.8 million workers in the most vulnerable industries during the COVID-19 crisis would be eligible for health insurance financial aid if they lose their jobs.

“People need to know we are here for them regardless of their ability to pay,” McDowell said.

Job or employer-sponsored health coverage loss counts as a “qualifying event” to get new coverage through the Affordable Care Act, which often offers subsidized plans. People have 60 days from that change to enroll in a new plan.

The Montana Commissioner of Insurance’s office has also pointed to non-traditional options like short-term health plans, which can be cheaper than what’s offered through the ACA but have been criticized for offering less thorough coverage.

Health providers are already concerned that this crisis caused some to delay getting needed care as people stayed home over the last month.

Buck Taylor, a spokesperson for Community Health Partners in Gallatin and Park counties, said providers are worried people will go without needed treatment even longer if the crisis has economic impacts that outlast stay-at-home orders.

The health center, designed to make sure people can access care despite what they can pay, saw a slight uptick in patients who can enroll in Medicaid. But not as much as expected.

Taylor said federal assistance, like small business loans to cover payroll during the crisis, has likely delayed the swell in uninsured patients.

“That’s pushed the potential onslaught back a bit, but we still are unsure of exactly what might be coming,” Taylor said. “Our message right now is we want people to not put off care or chronic disease management, which would lead to something more catastrophic down the road.”

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Katheryn Houghton can be reached at or at 582-2628.