MTPR

Medicaid Expansion Bill Clears Legislature, Awaits Governor's Signature

Apr 18, 2019

The long-contested bill to continue Medicaid expansion with new work and public service requirements for some of the people receiving benefits has cleared the Montana Legislature and is heading to Gov. Steve Bullock’s desk.

Rep. Ed Buttrey, a Republican from Great Falls, sponsored the 2015 bill that expanded Medicaid in Montana, and the so-called Medicaid Reform and Integrity Act this session to continue it.

"Anytime someone gets off addictions, or avoids a chronic mental or physical condition, it’s a huge win for the state of Montana," said Buttrey. "So I’m excited."

Gov. Bullock says he intends to sign House Bill 658, inking the final step in reauthorizing Medicaid expansion in Montana, which gives health coverage to around 96,000 low income adults.

Since state lawmakers approved Medicaid expansion in 2015 the coverage has been credited with cutting the state’s uninsured rate in half. It’s available to so-called abled-bodied adults making less than around $17,000 a year.

Democrats in the Legislature are praising the bill’s passage, although it is not the version of Medicaid expansion the party asked for in January.

"Neither side is probably super happy with that bill as it stands," says House Minority Leader Casey Schreiner, is a Democrat from Great Falls. "But it was what was best for the people of Montana given that we couldn’t just take the sunset off, unfortunately."

Democratic House Minority Leader Casey Schreiner announced the party’s bill to continue Medicaid expansion in Montana, Jan. 10, 2019.
Credit Corin Cates-Carney / Montana Public Radio

The biggest change some Medicaid enrollees will see is the new requirement for them to do 80 hours per month of work or public service requirements; what the bill calls "community engagement."

Work requirements were opposed by Democrats and a must-have for Republicans entering the legislative session.

Sen. Bob Keenan, a Republican from Bigfork, voted against the bill in the Senate along with top Republican leadership in both chambers.

"The work requirements are extremely weak. The exemptions are broad," Keenan says.

Rep. Buttrey disagrees with that characterization of new work requirements.

"We’re going to give everyone in that category chances to succeed," said Buttrey. "We’re going to offer them help. At the end of the day if they don’t want to take the help and they don’t want to perform those community engagements then they leave the program."

Gov. Bullock’s administration expects those requirements to result in more than 4,000 Montanans getting dropped from coverage.

House Bill 658 says the new requirements will go into effect July 1, 2020.