Last year, Congress passed President Donald Trump’s Big Beautiful Bill. That legislation increased eligibility checks and added work requirements for people on Medicaid.
Montana is overhauling its Medicaid system so it can verify whether people are working or meet a myriad of exemptions.
States have until next year to implement the new rules. Jessie Counts with the Montana Department of Public Health and Human Services told lawmakers this week that Montana will start July 1.
“We will be one of the few states in the nation that are able to go forward as an early adopter,” she said.
Counts says people won’t be kicked off Medicaid until September for not meeting the new requirements.
There are some doubts the state will be able to meet its self-imposed deadline. That’s because the Big Beautiful Bill only gave states a broad outline for how to implement the new rules. Federal officials aren’t expected to release detailed guidance until June.
Heather O’Laughlin is with the Montana Budget and Policy Center. She says until the guidance is released, the state won’t know how it’s supposed to check whether someone meets an exemption, like medical frailty.
“What does that mean? What types of conditions would be covered under medical frailty. Waiting for the guidance would be prudent,” O'Laughlin says.
Jennifer Tolbert with KFF, a nonprofit health policy research group, says until the rules are finalized, states are essentially guessing what the nitty-gritty requirements will be.
“If they guess wrong, they will then have to go back and make changes to systems, to policies, to procedures,” Tolbert says.
She says those kinds of changes take time.
In a written statement to MTPR, the state health department said it doesn’t expect additional guidance will impact its July 1 deadline.
