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'Capitol Talk:' Medicaid Expansion Politics; Tester Moves To The Center; Bullock Visits Iowa Again

Feb 15, 2019

Tonight on Capitol Talk: Medicaid politics; how Sen. Tester has moved to the center; and what's Gov. Bullock doing in Iowa again? Tune in now for these stories and more from the state Capitol, with Eric Whitney, Holly Michels and Rob Saldin.

Eric Whitney: Howdy and welcome to “Capitol Talk” our weekly political analysis show. I'm Eric Whitney filling in for Sally Mauk this week. I'm joined by Lee Newspapers capitol reporter Holly Michels and University of Montana Political Science Professor and Mansfield Center Fellow Rob Saldin.

There was some pretty big news out of Washington on Tuesday; the Senate passed a major public lands package. Montana's Republican Sen. Steve Daines says this one was different.

“It took public lands to bring divided government together. I think it's a testament to who we are as Americans, the value we place on our public lands,” Daines said.

EW: It's an interesting bite. I'd argue it took more than public lands to bring divided government together, since this public lands legislation was on the table last year and Congress didn't pass it. We’ll talk a little bit more about that in a minute. But Rob, what’s in the bill?

Rob Saldin: Well Eric, it's the biggest conservation bill we've seen in a decade. It combines over 100 bills from across the country and packages them into a single bill that runs 662 pages. And it creates over a million new acres of wilderness, creates new national park units, expands several existing national parks and so on.

The big items of interest in Montana are the permanent withdrawal of mining claims in the Paradise Valley just north of Yellowstone, and the permanent reauthorization of the Land and Water Conservation Fund, which takes money from offshore oil and gas drilling and directs it towards conservation. So those are the big ticket items for Montana, and they are quite significant.

EW: The Yellowstone Gateway Protection Act you mentioned and the Land and Water Conservation Fund reauthorization; that's something that politicians have been talking about literally for years in Montana. On Tuesday when this deal was announced I asked Sen. Tester why the bill that passed by a huge margin – it passed by 92 to 8 – why they couldn't get that done last year.

“I hope it didn't have anything to do with the fact that I was up for re-election, but it may have,” Tester said. “I hope it didn't have anything to do with people stopping conservation because they don't like conservation, but it probably has something to do with it. In the end, a package was able to be put together that got momentum, and that's a big part of it. And the momentum was a bipartisan momentum.”

EW: Rob, what do you make of Sen. Tester's comments there?

RS: First, Tester seems to be raising the prospect that this package didn't get through in the last Congress because, one presumes, Majority Leader Mitch McConnell, who controls the Senate agenda, didn't want to give him a win going into the election. And I guess that's possible. But on its face this actually seems to be pretty much in keeping with the way these public land bills have been passed over the last decade or so. And that is, at the very end of a Congress a whole bunch of bills from all over the country get cobbled together into one big package and that gets voted on in the lame duck session that is after the election. That's exactly what happened last year, or appeared to be happening, but then we're told it didn't get voted on because the Senate ran out of time. Who knows what was going on behind the scenes. But this actually seems to me to be fairly consistent with how public land bills have been dealt with.

The other thing that strikes me, just with Tester’s comments, the whole bipartisan bit. And we saw that from him this week too when it came to his comments about that committee he was on that put together the deal to avoid another government shutdown. It just seems to me he's really leaning into being that that moderate Democrat. You know, here we are at the very beginning of his third term. That's become a much bigger part of his presentation of himself as the years have gone by. Right? Remember when he first ran back in 2006, he ran as a real progressive. And there were a lot of people who saw his win in the primary against John Morrison as being an upset. Morrison was the guy who was running more on the Max Baucus moderate mold. And then when Tester got to D.C. there was a discernible difference between him and Baucus in terms of the people they surrounded themselves with and the way they carried themselves. Team Tester is definitely more progressive than team Baucus, but Tester really does seem to be claiming that moderate Democrat slot in the Senate. And that's perhaps because that lane has become more open to him as the national party has moved left. He has come to be the real moderate, or at least one of the real moderates, in the Senate. And with people like Claire McCaskill, the former Missouri senator, gone, there is a real opening there for him to become, kind of, the public face of that within the Senate. And of course that works well for him here at home too.

EW: He certainly didn’t run anything like a progressive in 2018. I mean, his first campaign ad was touting all the bills that President Trump had signed and how he can work with President Trump. So yeah, he’s not the Jon Tester of 2006.

RS: We have seen that shift over the years. I think one of the other things we see now from Tester is he's doing a lot more media, national media. Going on the Rachel Maddow Show, and you know, he was on one of the Sunday morning shows recently.

EW: Bill Maher.

RS: And Bill Maher. And so I think there is a space out there in the media universe, for sure, for the kind of face of the moderate Democrats in the Senate, and he does a good job of filling that.

EW: Well Holly, it's been a fairly quiet week in Helena. I think probably the most significant thing to happen was the release of this new analysis of the changes that Republicans say they want to make to Montana's Medicaid expansion. What is it that the Republicans are asking for, at least in the preliminary draft rules we've seen? And the GOP hasn't formally introduced their Medicaid expansion bill yet, right?

Holly Michels: Yes, we have not seen a Republican version of this bill formally introduced. There is a Democratic version out there that continues expansion. And it does so without work requirements, which are sort of the main piece that's in this Republican draft that we're focusing on right now. And Rep. Ed Buttrey, who's from Great Falls and is carrying this bill, has cautioned repeatedly that it's an early draft, it's still changing. So, hard to make any definitive statements, but it looks like about 80 hours of activities a month. That would be work, could be met with things like volunteering, or if you're unable to work there's other ways you can meet that hours requirement.

EW: Work requirements have been something that Republicans have been asking for in Medicaid and Medicaid expansion for years. I know in 2015 when Sen. Buttrey carried the bipartisan bill that enacted Medicaid expansion in Montana he initially wanted work requirements. The federal government told him that wasn't possible. And now with the Trump administration being more friendly to requiring Medicaid recipients to work, Buttrey's included that in his draft legislation. And one of the researchers at George Washington University who looked at the kinds of work requirements Sen. Buttrey is calling for came up with an analysis of what that would mean in terms of enrollment.

“We could see tens of thousands of people lose health insurance coverage. In total around 31,000 or 43,000, somewhere on the order of a third to maybe 45 percent,” says Leighton Ku, director of the Center for Health Policy Research at George Washington University.

Related: Study: Work Requirements Could Push A Third Off Medicaid Expansion

HM: Buttrey said that his draft has changed since that February 5th version that the researchers used to do their estimations. Buttrey said that he thinks some people would lose coverage under his plan, but not as many as Democrats in this study seemed to indicate. There's just not a lot of information at this point. What we will see once the bill is finally introduced is the Legislature has their own process to go through and analyze what impacts a bill would have. And so that might give us another idea once we have specific language there.

EW: We've heard from Sen. Buttrey that he doesn't think that these work requirements are going to result in a huge number of people losing their access to Medicaid expansion benefits. But Republicans have been saying that they think there are too many people enrolled in Medicaid expansion. They would like to see Medicaid expansion, the number of people enrolled, significantly smaller, right Holly?

HM: Yes, Republicans have said that for a long time, saying the program costs the state too much. And in 2015, estimates show that about 45,000 Montanans may enroll. We've seen now a little over 95,000, so the program is much larger than what was initially predicted.

EW: So we've got this Democratic Medicaid expansion bill that says basically, 'Continue the status quo.' The Democrats don't want these work requirements. Meanwhile, the clock is ticking and Medicaid expansion will expire at the end of June unless lawmakers come up with a bill to expand it. I'm just curious how you see this playing out. Is Gov. Bullock going to end up with a bill that has work requirements that he'd have to veto, or do you see the parties compromising? I just wonder what kind of final bill we're going to end up with.

HM: We spoke with Gov. Bullock this week and he thinks that there is enough time to work with Republicans to reach some sort of compromise. Both the Democratic bill and then Buttrey’s bill should have their initial hearings maybe March 9 or March 16, which is right at the middle of the legislative session. Buttrey’s made pretty clear that he wants to see those work requirements, which he calls “community benefits,” and Bullock’s made pretty clear that he doesn't want them in the bill. So not quite sure how that will turn out.

RS: You could end up in a situation where Bullock has a bill on his desk that's not what he wants. But the alternative to not signing that might be that the expansion ends, right? And you could get into a kind of showdown over that. And Bullock would have to decide whether he wants to sign that bill that he doesn't want, or let the thing expire. Of course he could veto it and kind of try to play a game of chicken, and force the Republicans to come back and pass an expansion that's more to his liking. Because I think one thing that has become clear, I'm not sure that anyone really wants this thing to go down permanently.

EW: Yeah, the Republicans we've spoken to have said they don't want to end Medicaid expansion, but they'd like to see some significant changes. There's going to have to be some horse trading to see how the parties can get together on that.

Related: Medicaid Expansion Grows Economy, Drives Employment

Also happening in Helena, we're starting to see some bills show up related to Child and Family Services. And this week Republican Rep. Eric Moore has a bill to address a problem he sees.

“One thing that we've seen is a classic problem within the department is turnover within its Child Protective Services, the people who care for the least among us,” Moore said.

EW: Holly, what kind of legislation is Rep. Moore proposing to deal with that turnover problem in the foster care system?

HM: So, Moore is looking at a bill that would create a program to help child protection specialists repay student loan debt. It would be up to $12,000. You would get about $3,000 after your first year of staying in that position, $4,000 after the second, $5,000 after the third.

That division has had a pretty big problem with both recruitment and turnover. They’re at about a 30 percent turnover rate right now, which is actually down from what it's been in years past. And that's because those jobs are really difficult. You're dealing with families and kids in crisis. You're dealing with people battling drug addiction, really long hours and high caseload because of that worker turnover. We have one caseworker who testified who said that they had about 52 children on their caseload at a time.

EW: Are you hearing about other bills related to Child and Family Services?

HM: Child and Family Services has had some scrutiny from the Legislature and other advocacy groups about the record number of children that have been removed and placed into foster care. And a lawmaker wants to increase that threshold so there has to be the risk of bodily injury to actually remove a child. Some people with the division spoke up against that bill saying that it might create situations where they'd need to leave a child in the home when there is still a risk to that child, though it might not be physical.

Related: Montana Lawmakers Consider Loan Repayment Program To Retain Foster Child Caseworkers

EW: Also happening In Helena, or I guess not happening in Helena, is Gov. Bullock, who’s absent today because he's visiting Iowa. And earlier this week he explained what it is he's doing there.

“I think that people can learn from the way that we do things in Montana. And it may not be perfect, but government typically largely functions. So, as I have on other trips, shared some of Montana's story, but that's really as far as it goes,” Bullock said.

EW: So Rob, the governor is headed over to Iowa to help the folks there with some Montana solutions. What's your take on why he's in Iowa?

RS: No offense to the Hawkeye State, but I don't think anyone travels to Iowa as much as Bullock unless they're running for president. These visits to Iowa and to New Hampshire, they serve a couple purposes. They help Bullock make connections and build support on the ground in the first state that holds the first nominating convention. But each of these trips also creates a whole cycle of news coverage, which keeps his name out there and in the mix, and he's been getting a lot of good press out of it.

HM: One thing members of the media did ask him this week, Republicans who are being critical of it are questioning about staff time and who he's taking with him on those trips. We did ask him about that and he did clarify that while some of his staff are going, they're going on their own dime, not on the state dime. So that's something that I think people have been wondering about.

EW: One more thing that happened this week was on Monday, Secretary of State Corey Stapleton was fined $4,000 by the commissioner of political practices. Rob, what happened there and what do you think is the significance?

RS: So, he announced his run for governor on official state letterhead, and there were some government email addresses in use with that as well. And you know, you aren't supposed to do that. In the big scheme of transgressions, this is pretty low on the scale.

Related: Montana Secretary Of State Corey Stapleton Fined For Ethics Law Violation

EW: I mean, he didn't really fight the conclusion by the commissioner of political practices. He apologized and said it wouldn’t happen again.

RS: Well yeah, it's pretty clear cut, right? You know better to just kind of apologize and move on.

EW: Well, I think that's all we have time for this week on “Capitol Talk.” I'd like to think Lee Newspapers Capitol Reporter Holly Michels, and University of Montana Political Science Professor and Mansfield Center Fellow Rob Saldin for joining us.