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Montana politics, elections and legislative news

Health Care Providers Hope State Budget Restorations Are Just The Start

More than 40 people came to the DPHHS hearing on Medicaid cuts Feb. 1, 2018 in Helena.
Corin Cates-Carney
More than 40 people came to the DPHHS hearing on Medicaid cuts Feb. 1, 2018 in Helena.

Health care providers who take care of some of the most vulnerable people in Montana say they’re thankful for state budget restorations, but they hope it’s just the start.

The Department of Public Health and Human Services (DPHHS) took public comment Thursday on some of the $30 million the agency will get back after $49 million were cut from its budget during last year’s special legislative session.

Those were on top of budget cuts approved by lawmakers and Governor Steve Bullock during the 2017’s regular session which also chipped away at Medicaid programs as the state tried to balance its finances after a projected revenue shortfall.

Providers and clients say those cuts made it harder for the poor, elderly and disabled in Montana to access healthcare.

Pat Noonan, of state contractor AWARE Inc., was one of a couple dozen people who attended Thursday's hearing in an echoey basement auditorium at the DPHHS office in Helena.

“Prior to these cuts, the system was already in crisis. So this restoration at least slows the spiral we’ve been in these chaotic couple of years, but it doesn’t fix it. It just stabilizes us back at the level of crisis we were working under before. Only now more exasperated by recent events,” Noonan says.

Many Montanans already had a hard time accessing care for behavioral health issues and substance abuse disorders before the cuts were put in place.

Some funding to pay for those services is getting restored. Others include a nearly 3 percent pay rate to doctors and clinics that serve Medicaid clients, including dental services.

As the cuts rolled out over the last year, Health Department Director Sheila Hogan acknowledged the difficulty of the situation and said the agency was working to minimize the impact of the budget changes.

Although Hogan said she has traveled all over the state seeking input and held a listening session ahead of the budget restorations, many providers said they still felt left in the dark.

In response to Montana Public Radio’s request for an interview following the public hearing, Hogan emailed the following statement:

“Governor Bullock directed DPHHS to restore the Medicaid provider rates, and today’s public hearing marks a key step in the process. We are pleased this process is moving forward, and we look forward to finalizing the rules soon.”

Providers during Thursday’s budget restoration hearing repeatedly expressed their gratitude to the health department for working to restore the funding for Medicaid programs, but they also said their trust in the administration is shaken.

Rose Hughes represents the Montana Health Care Association.

“There is a trust issue, there is a transparency issue and things just need to get to be a lot better,” she says.

Not everything that was cut within the health department over the last year and a half will be restored. And so while many health care providers are encouraged by the restoration moving forward, providers at Thursday's hearing said they want to see more plans from the health department about how services will continue to be funded.

Governor Steve Bullock is expected to release his next two-year budget proposal ahead of the 2019 legislative session in November. According to a health department spokesperson, Bullock has also tasked DPHHS to come up with a plan to redesign the state’s targeted case management program.

The Health Department is taking public comment on their planned budget restorations to Medicaid until October 5. It’s unclear when a final ruling on the restorations will be announced.

Corin Cates-Carney manages MTPR’s daily and long-term news projects. After spending more than five years living and reporting across Western and Central Montana, he became news director in early 2020.
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