Montana Passes Compromise Medicaid Expansion Bill

In late April, lots more eyes than normal were on the Montana legislature. Legislators were debating the Montana Health and Economic Livelihood Partnership (HELP) Act, which expands Medicaid to everyone below 138% of the federal poverty line. 

A coalition of legislators from both political parties passed the bill despite some procedural tricks designed to block legislators from bringing the bill to a vote. It passed both houses, and was signed by Governor Bullock. 

This bill closes the “healthcare gap” in Montana, where an individual without children makes too much for the current Medicaid program, and too little to qualify for health insurance subsidies outlined in the Affordable Care Act. 

If a good compromise is one where everyone is unhappy, then the HELP Act hits the mark. We are disappointed the bill includes a premium of 2% of an enrollee’s income, which may be a barrier for some low-income workers to meet. It also includes co-pays for doctor visits. Both of these provisions have been shown to decrease participation in Medicaid, which results in a rural population that’s not as healthy as it would be if it had access to affordable care.

Medicaid expansion, according to SB 405, ends in July of 2017, so the legislature will have to approve it again in a future session. Even with these provisions, we believe it’s better to expand the program to more low-income Montanans.

A study by the University of Montana estimates that this expansion will create 12,000 jobs, and about 60% of these will be in the healthcare industry. 

Passage of the HELP Act is good for rural hospitals and other health care providers. Many rural doctors, nurses, and healthcare administrators came to Helena to voice their support in hearings that lasted 6 hours due to the sheer volume of citizens wanting to be heard.

So what happens now? The state health department will now ask the federal Centers for Medicare and Medicaid Services for a waiver to include the compromise provisions. If approved, Montanans could see Medicaid expand as early as July of 2015.