MTPR

Senate Conservatives Vote To Table Medicaid Expansion Bill

Apr 5, 2019

Today's action at the state Legislature notched up tension over one of the 2019 legislative session’s biggest debates. This morning a group of conservative Republicans voted to stall in a committee the bill to continue Medicaid expansion in the state.

Park City Republican Sen. David Howard, the chair of the Senate health committee joined other conservatives attempting to block House Bill 658 from reaching a full debate in the Senate. However, he expects it to move forward.

"Certain Republicans have teamed up with the Democrats and the governor to get it through. They many times call themselves 'Solution Republicans,' and I submit to you that they ought to add another 's.' This 's' is a 'Socialist Solution Republicans.' That’s not a Republican bill. It’s a Democrat bill."

Hours after the bill was tabled in Howard's committee, Senate Majority Leader Fred Thomas moved to nullify the committee’s vote. The expansion bill is now set for a new hearing in a different committee first thing Monday morning. 

House Bill 658 is carried by Republican Rep. Ed Buttrey from Great Falls. Buttrey sponsored the 2015 bill that established Montana's current Medicaid expansion. He spoke in support of his new proposal, which he calls significant reform during the Senate health committee today.

"I'll be one of the first to admit that the current program has been very good for our state and its citizens," Buttrey says. "But I’ll also tell you that I think we can make it better."

The 2015 expansion extended Medicaid to so-called "abled-bodied adults" who make no more than about $17,000 a year. Many credited it with cutting Montana’s uninsured rate in half, substantially reducing unpaid bills at hospitals, and boosting to the state economy.

Montana currently pays 7 percent of the costs of the program, with the rest picked up by the federal government under the Affordable Care Act, also known as Obamacare. Montana’s share of the costs will grow to 10 percent 2020, and stay at that level into the future.

Buttrey’s new proposal to continue Medicaid expansion would make big changes, including requiring 80 hours per month of work for certain people enrolled in the program.

Democrats that have pushed back against adding work requirements are now backing Representative Buttrey’s bill. They flipped their opposition following significant amendments, and the failure to win any Republican support for their proposal to keep Medicaid expansion in the state going as-is.

Representative Mary Caferro, a Democrat from Helena, says Buttrey’s bill will allow people who work, but don’t make enough to afford health insurance, the ability to get coverage.  

"Many of them, for the first time in their lives have stability and are able to stay in the workforce because they have a consistent source of healthcare," Caferro says.

Sarah Caniparoli, who spoke during the bill’s first hearing in the Senate today, says she’s one of those people Caferro is talking about.

Caniparoli says she lives in Great Falls and until recently had undiagnosed health conditions that left her with extreme vertigo. 

"I had to give up working because the symptoms were debilitating."

Once she got coverage under Medicaid expansion, Caniparoli says she could afford a doctor, medical tests, and medication.

"And without those, I wouldn’t be able to go back to school, volunteer, and I certainly wouldn’t be able to go back to work," she says.

Some Republicans are objecting to changes made to Buttrey’s bill before it was passed out of the House. They say those changes weakened the work requirements they want to see in the expansion policy. Other conservatives are resisting the policy all together, calling it an overreach of government.

However, supporters and opponents of the bill alike say Medicaid expansion has enough votes to continue, giving it a path to Governor Steve Bullock’s desk. Bullock says the bill is imperfect, but is urging lawmaker to pass it out of the Legislature.  

Sen. Jason Small, a Republican from Busby, is carrying the bill in the Senate.

"Everybody up here knows the trajectory it’s gonna take here."

House Bill 658 is scheduled for an 8 a.m. hearing Monday in Senate Finance and Claims, which Small says is a much more friendly place for the bill to be.