Medicaid

In most states, people with Medicaid coverage will have to prove they're working, volunteering or studying, starting Jan. 1. But Montana is starting that early, and it's sowing confusion and anxiety.

State health officials last week told lawmakers the rollout of work requirements for people on Medicaid is going well. Montana soft-launched Medicaid work requirements July 1, months ahead of the federal deadline to do so.

Montanans on Medicaid are now required to show they’re working or qualify for a wide range of exemptions. Some people on Medicaid say the state hasn’t been clear about when they should submit their paperwork.

Medicaid advocates rallied at the state Capitol Wednesday to voice their opposition to new work requirements. They argued the state is rushing to roll out new rules that will impact who still qualifies.

As of July 1, Montanans on certain Medicaid programs will be required to work or volunteer 80 hours every month or file for an exemption. The state is among the first in the country to roll out work requirements under a federal law passed last year. But, officials haven't finished setting up everything they need to implement the new rules.

Gov. Greg Gianforte and state health officials have agreed to withhold a pay bump for Medicaid providers. The move will resolve a budget shortfall for the public health insurance program.

Federal officials released the final rules for Medicaid requirements this week. Hiding among the nearly 400 pages of regulations is a significant change that could make it harder for Montanans to stay on the public health insurance program.

Montana’s top law enforcement officer joined Vice President J.D. Vance for an anti-fraud roundtable this week. President Donald Trump earlier this year declared what he called a “full-scale war” on fraud in public benefit programs like Medicaid and nutrition assistance.

A lawsuit argues the state’s process for redetermining Medicaid eligibility after the pandemic was intentionally devised to kick as many Montanans off the program as possible. Both state and third-party analysis found a large portion of the people unenrolled still qualified.

Some state Medicaid services are on the chopping block due to a budget shortfall. The state health department estimates it will need at least another $7 million, but isn’t saying what services might be cut.