On Monday, the next phase of Montana’s Medicaid expansion was announced at a job service center in Great Falls. Expanding Medicaid under the Obama Administration’s Affordable Care Act was a hard sell to Montana Republicans in the 2015 legislature until Republican Senator Ed Buttrey introduced a workforce initiative into the healthcare bill, among other changes.
That bill, the Montana Health and Economic Livelihood Partnership – known as the HELP Act - created an option for new Medicaid enrollees to receive job assistance in addition to health care coverage.
Governor Steve Bullock announced the workforce initiative at the Great Falls Job Service.
"Through HELP-link, services will be made available to HELP Act recipients, insuring that folks aren’t just getting the healthcare they need to be productive citizens, but they are also getting the one-on-one assistance and training referrals they need to climb up our economic ladder."
Bullock calls the HELP Act a bipartisan success.
Ed Buttrey of Great Falls sponsored the act in the Senate. He says HELP-link is about connecting healthy workers with jobs.
"It can be as simple as resume writing or learning how to dress for an interview or those types of tips."
Buttrey hopes those tips will land Medicaid recipients good enough jobs that they will eventually wean themselves off of public assistance.
"And then when the person feels they are happy in their career they would drop off and hopefully they would get off the HELP Act soon onto the exchange and further and financially independent."
That kind of thinking, and offering Medicaid recipients help getting jobs, made the expansion of what some call “Obamacare” palatable for enough Montana Republicans for the HELP Act to pass.
As the debate over Medicaid expansion continues across the country, Buttrey says Montana’s unique take on Obamacare could be a plan conservative red states seriously look at adopting: combining healthcare and economic development.
"We were the first state to realize and to innovate into our law that the two have to go hand in hand. I definitely want to see the economic development part of the bill succeed and that is what I am going to watch most closely."
Buttrey says there isn’t much additional government cost for HELP-link services because it uses the existing services of Montana Department of Labor and Industry.
Pam Bucy, who runs the Department, says the legislature did allow her office to hire more staff for HELP-link services, but there hasn’t been the need for that yet.
"We are really trying to save those resources for training dollars. We would much rather if we can spend money getting the client the training services they need. So, right now there is only one human being paid out of HELP-link money."
The HELP-link job assistance part of the HELP Act isn’t mandatory for Medicaid enrollees. Senator Buttrey says it will be up to the state to let people who enroll in the expanded Medicaid program know about the job services available.
He says the Help Act has so far enrolled more than 27,000 people. A Department of Labor and Industry spokesperson said over 800 people have taken the initial HELP-link survey and 50 people have signed up to take the next step in job services program.
Senator Buttrey and Department of Labor and Industry officials said the program is just starting off and more numbers will be coming out as the program develops.
The cost of providing HELP-link services and the Medicaid bill’s ability to create economic growth may influence the future of what Senator Buttrey calls the most conservative health care plan in the country.
Right now, Buttrey says he isn’t hearing too much negative discussion about the HELP Act or repealing the law, but he says that legislators will be watching closely to see what kind of data that comes out of the job services program.
"If we get to four years and the state is not succeeding in getting people out of poverty and getting rid of job barriers and barriers to employment then we are going to have major changes to make or potentially the plan could go away."
Montana’s HELP Act expires in 2020, unless re-affirmed by a future state legislature.