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Montana politics, elections and legislative news

Montana Democrats Resist Significant Changes To Medicaid Expansion With New Bill

Rep. Mary Caferro, D-Helena. File photo.
Montana Legislature

Montana Democrats formally introduced their bill Thursday to continue Medicaid expansion in the state. However, it's unclear if it will win any support from the Republican majority.

In offering the so-called Keep Montana Healthy Act, Democrats say they will resist any significant changes to Medicaid expansion, which currently extends health coverage to around 95,000 low-income adults in the state.

When expansion passed in the 2015 legislature it was sponsored by a Republican, but the GOP is now calling for major changes to it.

A competing Republican proposal to keep expansion going past its June sunset would require some recipients to perform a quota of work or other activities.

However, Mary Caferro, a Democrat from Helena, says that isn’t an option.

“What we have in front of us is the compromise bill.”

Caferro is carrying the Democrats’ proposal, House Bill 425. Along with making Montana’s Medicaid expansion permanent, it would increase fees on hospital beds and outpatient revenue to help pay for it.

Caferro says these fees raised from hospitals could amount to about $15 million a year.

Some Medicaid recipients also pay premiums, amounting to nearly $7 million in expansion’s first two years.

HB 425 also asks the Legislature to appropriate $6 million to fund the state’s HELP-link work training program.

However, Republican Speaker of the House Greg Hertz says his party has its own plan.

“Starting first and foremost with work requirements.”

Hertz says Republicans will also push for Medicaid expansion enrollees to go through regular health and job assessments. Republicans say they will also ask for a person’s assets to be considered in determining eligibility, beyond current guidelines focused on income.

The majority is also considering whether to make the expansion permanent, as is called for by Democrats. Hertz says Republicans are interested in putting another sunset on the program.

The House Speaker says there are some members of his own party that will likely oppose the continuation of the expansion program. And Democratic leaders say any Medicaid expansion proposal including workforce requirements is a non-starter with them.

The future of health care program for low-income adults remains up in the air.

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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