The committee that oversees Montana’s Medicaid expansion is expected to recommend that it continue beyond its 2019 sunset date.
A draft document released Friday suggests expansion has helped nine percent more adults who are eligible for Medicaid join the workforce in Montana. It also says six percent more of Medicaid eligible adults with disabilities are joining the workforce.
Montana lawmakers voted to expand Medicaid here in 2015 in part because the bill doing so included incentives to help those receiving the health coverage to get jobs, or better paying jobs.
There are now more than 96,000 people in the state who receive health coverage under the program known as the HELP Act.
April Grady is from Manatt Health, which completed a study on the state’s Medicaid expansion program along with the Montana Healthcare Foundation.
"Montana's uninsured rate has fallen by more than half," says Grady.
Grady presented the study’s findings to Montana’s medicaid expansion oversight committee last week.
In mid-August the oversight committee will send recommendations to lawmakers and Governor Steve Bullock about how to approach the expiration the state’s Medicaid expansion program next year.
However before lawmakers take up the idea of renewing the program during the 2019 session, voters will likely have the option of making that decision through ballot initiative I-185.
I-185 proposes raising the state’s tax on cigarettes and chew to $3.70 a pack or can to, in part, fund the continuation of the Medicaid expansion program.
Amanda Cahill is the director of government relations for the American Heart Association and a leader of the campaign.
"This has been a big priority for many of us as health organizations," says Cahill, "and this is the solution we came up with, it delivers a one, two, punch of keeping Montanan’s covered and reducing the death and disability from tobacco use across Montana."
Republican Senator Ed Buttrey, who sponsored the HELP Act when it passed in 2015, says if voters reject I-185 some lawmakers will take that as a sign to discontinue Medicaid expansion in the state.
"And if that were to happen I think it actually creates a much higher hill for us to climb if we indeed want to continue the program because there are going to be a lot of folks who say, ‘The people have spoken. This wasn’t about taxes. This was about the HELP Act'" says Buttrey.
Earlier this month a group of Republican lawmakers attempted to call a special legislative session to pass a referendum asking voters to consider requiring Medicaid recipients to work. Some also want Medicaid enrollees to have to list their assets to prove they need government help.
The special session call failed, but Buttrey says the legislature could take up those ideas when they debate the HELP Act in the 2019 session.
A federal judge recently blocked workforce requirements put in place in Kentucky's Medicaid system and Buttrey says some Montana lawmakers are watching closely to see how that case unfolds in appeals.
"We feel like engagement and getting folks out and either creating a benefit to their community, or getting job training, or enhancing their work environment - we think that's good for the individual," says Buttrey. "And that's what is going to get ultimately decided by the courts: is Medicaid expansion simply about healthcare or is it also about the financial well being of the individual?"
A spokesperson for the I-185 campaign to reauthorize Montana medicaid expansion said the group does not have a position on workforce requirements or additional assets tests for those who receive Medicaid benefits.
The reauthorization and funding of Montana’s Medicaid expansion program is backed by some of the largest industry groups in the state.
John Goodnow is the chair of Montana’s Medicaid expansion oversight committee and the CEO of Benefis Health System.
"It’s simply too important to not continue," says Goodnow.
Along with data showing the Medicaid expansion leads to better health outcomes, the program’s oversight committee also points to studies that say the expansion is a boost for healthcare businesses.
The reduction of uninsured people in Montana is increasing hospital profitability because more people have coverage plans to pay for their healthcare, meaning hospitals are giving away less care for free.
A study from Manatt Health and the Montana Healthcare Foundation says hospital net revenues from patients increased by $216 million, more than 11 percent, between 2016 and 2017.
The Medicaid expansion oversight committee’s draft recommendations say hospitals in states that have expanded Medicaid are six times less likely to close than hospitals in non-expansion states.
Support for reauthorizing Medicaid expansion through ballot initiative I-185 is getting backing from Benefis Health System, Kalispell Regional Medical Center, Providence St. Patrick Hopstital, The Montana Primary Care Association, and other healthcare groups from around the state.