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'Capitol Talk': Medicaid Expansion Passes; Republicans Divided; The Race For Governor Begins

Apr 19, 2019

Tonight on Capitol Talk: It was hard-fought, but Medicaid expansion will continue in Montana, and Gov. Bullock is celebrating the big legislative win. Moderate Republicans once again tipped the scales on Medicaid and other big items. Greg Gianforte appears ready to leave Congress, giving Democrats a glimmer of hope of retaking the seat. The Legislature is ready to wrap up after the Easter break.

Sally Mauk: Welcome to Capitol Talk, our weekly legislative analysis program. I'm Sally Mauk and I'm joined by University of Montana Political Science Professor and Mansfield Center Fellow Rob Saldin and Lee Newspapers Capitol Reporter Holly Michels.

And Holly, two important bills are headed to the governor's desk for his signature: one to continue Medicaid expansion and one to fund millions of dollars worth of infrastructure. After teetering near death, in the end, Medicaid expansion passed fairly easily with some work requirements and a 2025 expiration date.

Holly Michels: Yep, this bill is on its way to Gov. Steve Bullock, who said he will sign it. It was arguably one of the biggest bills of this session; we had an all-day Saturday hearing on it, hours and hours of long floor sessions, debating, committee hearings. And the fight over expansion really even started before the session gaveled in. We had health care associations, hospital groups funding massive studies showing the economic and health benefits of the program, and back in October we had about 70 Republican lawmakers make it pretty clear in a letter to Bullock that they wanted to see work requirements added to the program. So all of that really set the scene for what we saw this session.

The bill was carried by Rep. Ed Buttrey, a Great Falls Republican who carried the original bill that expanded Medicaid in 2015. And his bill this session went through several iterations. One of the biggest changes we saw was changes to the work requirements and exemptions to those requirements as well as how people would account for the hours they work to meet those requirements. With the amendments that were made in March that lowered the number of people who are expected to lose coverage from about 59,000 to 4,000 under the work requirements. Those changes, as well as some others, made the bill more palatable to Democrats who had their own bill to continue expansion without work requirements. That was voted down in March. But Republicans are pretty critical of the work requirements that are in the bill now, saying they're basically toothless. But those comments are also coming from Republicans who wouldn't have voted for the bill anyway.

Other big changes we saw as this bill made its way through the process was the removal of a non-severability clause, which would have ended the whole program in Montana if there was a successful court challenge to work requirements. And we saw that happen as this session played out when a federal judge struck down work requirements in Arkansas and Kentucky. The Senate was successful, as you said, in putting on another sunset date on this bill of 2025. Democrats have said that that's something that they'll stomach just to get this program continued. And Buttrey said that he expects enough changes to the federal Affordable Care Act that created the option for expansion, so he thinks it would make sense to review the program in six years anyway.

Mauk: A couple of key senators, including Republican Duane Ankeny of Colstrip, changed their votes to keep Medicaid expansion alive. And Ankeny had tried to hold the bill hostage to another bill to help NorthWestern Energy buy more coal from the plant at Colstrip.

“It was never my intent from the start to kill the Medicaid expansion bill,” he says. “My intent from the start was to try to bring some pressure to get the governor to negotiate with us on pro-jobs, pro-economy, pro-revenue bills.”

Mauk: But that pressure didn't work, Holly. But components of the coal bill may be revived in a free conference committee, correct?

Michels: Yep, so we saw these two bills collide in the sort of closing weeks of this session here. We had Republican cosponsors pull their support for the Medicaid expansion bill, but as we just heard they changed their mind too. We first saw Sen. Russ Tempel, one of those Republicans. He said that his concern over the financial security of rural hospitals finally swayed him. Ankeny and Sen. Jeff Welborn of Dillon also voted finally to get expansion out of the Senate.

The Colstrip bill, Senate Bill 331, which would have let NorthWestern Energy pass on about $75 million of the cost of acquiring a greater share in the coal-fired power plant in that town, in its initial form that bill was voted down in the House. But there is a remaining vehicle in place that could absorb some of the intent of that legislation. That's House Bill 597 from Billings Republican Daniel Zolnikov. That bill was sent to what's called a free conference committee, and in that committee lawmakers can make changes to the bill. It has a very broad title to generally revise utility regulation, so there's a lot of things that could be amended into that bill that were in the initial Colstrip legislation, and that could become a vehicle to accomplishing some of the things Duane Ankeny or Sen. Tom Richmond, who carried that Colstrip bill, want to see done.

Mauk: Well, we'll keep an eye on what that conference committee does.

Rob, Medicaid expansion and the bill to use bonding for infrastructure projects passed because a handful of moderate Republicans, like Duane Ankeny and like Ed Buttrey of Great Falls, once again sided with Democrats. Here's Buttrey.

“Anytime someone gets off addictions or avoids a chronic mental or physical condition, it's a huge win for the state of Montana. So I'm excited,” he says.

Mauk: But there are conservative Republicans, Rob, who are not excited, not happy, with how this has played out.

Rob Saldin: Yeah that's right, Sally. I mean this has been the classic combination now for several legislative sessions. You have the Democrats voting unanimously, and then you have this group of so-called moderate Republicans joining with them to pass some of the really big-ticket items that come before the legislature. That's what happened with Medicaid. And what that really reflects is a deep divide within the Republican Party in Helena. It's been a bitter divide; it's personal, in many cases, at this point. And you have kind of the hard line conservatives, which is the majority of the Republican caucus, and then the other group, which they deride as moderates. A lot of the moderates resent being called moderates. They prefer to be called the solutions caucus; this time they've gone by different names. But that's really been one of the defining features of the Legislature now for a number of years, and we see it playing out that way again here at the end of this session.

Mauk: There was one Republican legislator who something to the effect of “Voters thought they were sending 58 Republicans to the House, but really they sent only 38.”

Saldin: Right. And I mean there have been efforts to primary some of these solutions caucus members. I mean you can't understand the Montana Legislature these days without understanding this split within the party — it's really been a defining feature. And I see no reason to think that it's going to come to an end anytime soon.

Mauk: One of the people happy with the way this has played out, of course, is Democratic Gov. Steve Bullock, and he's been gloating about it a little bit this week on Twitter.

Saldin: He has. I mean he has a little room to gloat, I think. It's a big win for the governor. You know, getting Medicaid expansion passed through a very Republican Legislature is, I'd say, probably his biggest achievement as governor, and now he's managed to do that twice. You know, that's not only a big win on policy grounds for the governor here in Montana, but that's something he can also take to Iowa and take to New Hampshire and point to as example number one of his ability to work across the aisle, get things done, this kind of thing, and use that as a way to distinguish himself against some of the other people running for president.

Of course I'd also say we need to note that this is a big win for a lot of other folks too. People who are covered under the Medicaid expansion obviously, but also within the Legislature, Ed Buttrey, who Holly mentioned, you know carried the original legislation and then again through this session. He has had a tricky balancing act to play throughout this process. And he's had to endure criticism from all sides, but in the end he managed to get the thing through.

Mauk: Holly, another bill that Democrats are very happy to get through this Republican-controlled Legislature is the bill to transfer oversight of for-profit wilderness schools for troubled teens from the Labor Department to the state Health Department. And they didn't get everything they wanted in that bill, but they got that major concession.

Michels: Yup, this bill faced several challenges as it worked its way through the session. It was once tabled in committee, but Sen. Diane Sands of Missoula asked for another vote and that got it out to the full Senate. There's also another last-minute change to the bill that eliminated minimum standards for training people that work at these programs. And it also got rid of the requirement that staff have basic qualifications and certifications.

Sands said that she was frustrated with the amendment, but still believes people who testified on the bill — people who have been through these programs and worked at them — they still think that this will put into place better protection for teenagers at these schools. The legislation comes after a yearlong look by the Missoulian newspaper at these programs. They found that over a dozen years this soon-to-be defunct board received about 60 complaints about the programs, but there was never really any real discipline. This bill that Sands brought has been about 20 years in the making since the creation of this board that was made up of mostly people from the schools that they were regulating. The Legislature has long been aware that that was an issue, but really hasn't had the appetite or the ability to get anything done until this session.

Mauk: It was a case of the fox guarding the henhouse before, certainly.

Rob, Congressman Greg Gianforte told several news outlets this week that he may jump into the race for governor. And here's what he told MTN News.

“I've been getting a lot of encouragement to run for governor. I have not made a final decision, but I'm seriously considering it,” he says.

Mauk: It sounds to me like he's done with Congress, Rob.

Saldin: Absolutely. This is not a surprise, but it is still notable if only because it's the first time that Gianforte has actually come out publicly and said that he's looking at running for governor again. But you know, he’s going to be jumping into an already crowded field of candidates on the Republican side. You have Tim Fox, the attorney general, Secretary of State Corey Stapleton, Al Olszewski, the senator from up in the Flathead, among others. And, of course, now we know for sure that it’s only a question of time before Gianforte officially jumps in too.

And I do think that raises a question of whether this will cause some shifts in what we see amongst the candidates. I think Fox will stay in for governor. But I'm not quite so sure about Stapleton and Olszewski, because now with Gianforte leaving the House there's going to be an open seat in Congress. Matt Rosendale, the state auditor who lost that close election, of course, last year to Jon Tester, is widely expected to go for the House. But I wouldn't be entirely surprised if Stapleton and Olszewski, both of whom have previously run for seats in Congress, that they might shift gears and go for that House seat rather than governor, just because that lane to get the nomination on the Republican side for governor, that is really crowded — it's going to be tough. It might have an easier shot, higher probability on the House side. And one other thing, I think, probably worth pointing out: that this is really good news for Kathleen Williams or whoever ends up getting the Democratic nomination for that House seat. It's just really tough to dislodge an incumbent like Gianforte, who has won multiple times. And so I think whoever the Republicans put up is not going to be in quite as strong a position as Gianforte would have been if he'd decided to remain in Congress and run for re-election.

Mauk: And that Republican primary in the governor's race will illustrate what we talked about earlier in the Legislature, in that it will be conservative Republican running against moderate Republican or more than one, right? This split in the party will be evident in that gubernatorial Republican primary.

Saldin: Yeah, absolutely. And that's why just how many candidates you have and how many are on one side or the other could really be a defining thing, right. Whereas if you just had two candidates it might go one way, but if you have, say, three candidates in the conservative lane and one moderate, well, the conservatives split up that part of the vote and the moderate manages to get in, you know. Or it could be the other way around: you have a number of moderates and it clears the lane for the conservative. So it really does matter who is there among the candidates and how many are on which side of this divide within the Republican Party.

Mauk: Holly, the Legislature is on its Easter break right now, and they still have a lot of business to tie up, most notably the budget, but it seems to me they're close to adjourning after they return from their Easter break.

Michels: Yeah, what we're hearing up here is that next Thursday is when most people would like to be done. This past Thursday the House actually jumped a legislative day which is a way to bring the end of the session closer. We're not quite to this point yet, but on Day 87 either the House or Senate can vote to sine die; they don't need permission from the other body to bring an end to this session. There is a mood to end this legislative session. It's warmer outside. People are just kind of over being in Helena, it feels like. But as you said we've still got the budget in play. There's a lot of companion bills that can make some pretty big changes at the last minute. The Colstrip issue is still unsettled, and we might see a last-chance effort at funding a statewide preschool program before we're done here. So, getting close to the end but still some big items left to be settled.

Mauk: We will be following that next week.

And you've been listening to Capitol Talk, our weekly legislative analysis program. I’m Sally Mauk and I've been speaking with Lee Newspapers Capitol Reporter Holly Michels and University of Montana Political Science Professor and Mansfield Center Fellow Rob Saldin. And Holly and Rob, as we approach the end, we'll talk again next week. Thank you.