Medicaid Expansion is a win-win

Thursday, March 7, 2019

Medicaid Expansion is a win-win for residents of Carbon County. Medicaid Expansion, passed during the 2015 legislature with bipartisan support, has provided more than 96,000 Montanans, rural and urban, with access to much needed health care services. In Carbon County, almost 800 of our 10,600 neighbors now have health care through the program. Medicaid Expansion provides low-income adults access to affordable preventive, mental health, substance use disorder treatment and other services that improve individual and family health, critical for a healthy Montana workforce. 

Medicaid Expansion has been a critical payment source for rural health care providers; unfortunately, rural residents historically are more likely to be uninsured. In fact, Montana hospitals’ uncompensated care costs have been reduced by more than $100 million in 2016. According to UM research, the program generates a substantial amount of economic activity, e.g. approximately 5,000 jobs and $280 million in personal income each year. 

Unfortunately, there is misinformation being circulated about the Medicaid Expansion issues facing the 2019 legislature. In truth, all but the lowest income enrollees pay premiums for their coverage, and most have copayments for the services they use. Montana Medicaid Expansion includes a “shared responsibility” commitment. Nearly 7 in 10 enrollees are already working, ranking Montana in the top 10 for all states. Of those not working, more than 1 in 3 are ill or disabled; the remainder were taking care of family, in school or were looking for work but could not find it. 

The original Medicaid Expansion legislation authorized the program for four years. For the first few years, the Federal Government paid between 100% and 93% of the costs. These Federal dollars replaced 

State spending for some health services, saving the Montana general fund. 

During the 2019 legislative session, legislators are debating the program’s reauthorization and how the state will financially support its share (10%) for Medicaid Expansion. Last November, voters rejected the tobacco tax idea (to fund the program) but did NOT reject continuing Medicaid Expansion. There is growing bipartisan consensus that Expansion should be continued. Montana does not have a debt problem; the constitution does not allow the state budget to be balanced with debt. 

This past week was transmittal break and many legislators are back in their districts, holding public forums and discussions. It’s disappointing that our MT State Rep. Berglee did not have any type of public meeting. But, there is still time to voice your support for Medicaid Expansion. There will be a rally on March 16 at the capitol at noon. Or, contact our representatives Representative Berglee and Senator Howard at 406-444-4800 asking them to maintain increased access to health care. 


Submitted by Kim Gillan who formerly served as the Regional Director for USHHS, Region 8 (which includes MT) and in the MT State Legislature, 1997-2012. 



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