MTPR

Medicaid Bill Revived, Moves To Full Senate For Debate

Apr 8, 2019

A Republican redesign for Montana’s health care program for low income adults advanced in the state Senate today. That opens a path for the Medicaid expansion program — including work requirements — to reach the governor’s desk.

Three Republicans joined seven Democrats Monday morning to move the bill out of the Senate finance committee, approving continuation of Montana’s Medicaid expansion program, but with some changes.

The proposal carried by Republican Rep. Ed Buttrey from Great Falls was briefly tabled last week. Some conservative Republicans continue to push back against extending Medicaid to so-called able-bodied adults. Before Medicaid expansion passed in 2015, the health coverage was only available to children, pregnant women, the elderly, and people with disabilities.

House Bill 658 was revived soon after its setback last Friday and will now move to the Senate floor.

Before it advanced, Monday, lawmakers changed a few of the bill’s funding sources at the request of Representative Buttrey.  

Lawmakers removed a tax on insurance premiums sold by the Montana State Fund and raised a tax on hospitals. 

Rep. Buttrey has asked lawmakers to not pass other changes to the bill since it passed early votes in the House.

"I think we’ve got a good solution here and one that we can — if you can see fit to pass it — we can take to the floor and we can get this done."

Several Republicans, including Bigfork Sen. Bob Keenan, object to how House Bill 658 is moving through the Legislature, with few changes other than those called for by Rep. Buttrey.

Early in this year’s legislative session Keenan worked on his own bill to continue the Medicaid expansion program, however the bill was never introduced.

"I’ve never seen so much resistance to the Senate amending a bill, changing it, maybe making it better," Keenan said.

Nine Republicans are currently signed on to Buttrey’s bill as co-sponsors, giving it enough support to pass in the Senate. Democrats have so far voted in unison to support the policy.

Democratic Gov. Steve Bullock has called the bill imperfect, but asked lawmakers to pass it.

A fiscal analysis from the governor's office estimates more than 4,000 people will lose their coverage under the health care program because of new work requirements put forward in the bill.

House Bill 658 requires 80 hours per month of so-called community engagement for certain people enrolled in Medicaid expansion. Those requirements, in what some are calling a compromise bill, are critical for many Republicans supporting it, but cause heartburn for Democrats.

If the Legislature does not pass a bill to continue the program that now covers around 96,000 low income adults, it will expire at the end of June.

House Bill 658 is expected land on the Senate floor for debate in the coming days.