A bill to extend Medicaid to Montana's working poor won preliminary approval in the Montana House on a 54 to 46 vote. But before it could, supporters of Senate Bill 405 had to fight off another attempt to kill this bill again in committee.
The last surviving bill on Medicaid expansion has been the subject of numerous procedural fights with the most intense action over whether it could come to the House Floor for debate. That finally happened Thursday.
Republican Representative Frank Garner of Kalispell says he once lived in a house that was ten feet wide with tires underneath. He says he knows what it's like when times are tough.
"It’s because I want to see these people move out of that area that I support this bill," Garner said. "I didn't support full Medicaid expansion. I voted against it and I long said I don't."
Garner says one reason why he supports Senate Bill 405 is it attempts to help the working poor get a better paying job.
"I didn't come here not to make hard decisions, and I think this is a hard one," said Garner. "I think it's one of the most important ones in our state. I think the act of doing nothing is not going to solve the problem that we have for the people who find themselves in the range that this bill covers. Today I chose to do something that I think will help move them out of poverty."
This bill is aimed at people who earn 138% of the federal poverty level. They earn too much to qualify for traditional Medicaid but not enough to buy insurance on the federal Marketplace under the Affordable Care Act.
But opponents argue Senate Bill 405 is not the cure to end poverty. Instead they say it will continue dependence on government programs. House Appropriations Chair Nancy Ballance says this is a massive new welfare program.
"Fifty-five thousand Montanans, 5.5 percent of our population, working aged adults with no disabilities, no children who would be added to a new medical welfare program at a time of extreme and growing shortages of medical providers" Balance said.
Ballance says Medicaid was designed to provide coverage for the poorest of the poor and the severely disabled, not for able-bodied, working-aged, childless adults.
"This is a tragedy, especially for the disabled poor but also for the working poor," she said. "This bill is facilitating their dependence upon government and reducing their incentive to work and inhibiting their ability to become independent."
This bill is touted as a bi-partisan, compromise bill. While it extends Medicaid coverage at the same time participants would have co-pays and premiums. It attempts to address malpractice lawsuits, as well as waste, fraud and abuse.
Several provisions would require waivers from the federal Centers for Medicaid Services. Opponents tried unsuccessfully to amend the bill. Just over an hour into the debate, Republican Representative Alan Doane rose and made a motion to end it.
That brought an objection from Republican Representative Art Wittich who said he still had two more amendments. The chair of the day, Speaker Pro Tem Lee Randall, ruled Wittich out of order.
That allowed the vote where 13 Republicans joined all 41 Democrats in supporting the bill. But that action wasn’t the end of the procedural maneuvering. When House Majority Leader Keith Regier stood to re-refer the bill to the Appropriations Committee, Minority Leader Chuck Hunter objected.
"We have heard from the Appropriations Committee, many members, including the head of the committee’s stance on this bill. To send this bill down there is to kill it."
So the House voted on the motion whether to send this bill to the Appropriations committee and it was rejected 45 to 54. The bill faces a third and final vote. If it passes, it will return to the Senate because it was amended in the House.
