A proposed voter-initiative to expand Medicaid for at least 70,000 low-income Montanans has passed its legal review by state officials, allowing supporters to start working to qualify it for the November ballot.
Attorney General Tim Fox’s office on Tuesday found the initiative to be “legally sufficient,” one month after he identified problems with an earlier version of the initiative proposal.
“We’re just happy that we have the (approval) in hand, so we can start talking to Montanans about it,” Kim Abbott, president of the Montana Healthy Initiative, said Wednesday. “We’re one step closer to 70,000 Montanans getting the health care they need.”
Backers of the initiative have until June 20 to gather at least 24,175 signatures of registered Montana voters to qualify the measure for the Nov. 4 ballot.
Abbott said supporters hope to start distributing petitions for signatures in a couple of weeks.
If approved, the measure would expand Medicaid eligibility in Montana to cover all people earning up to 138 percent of the federal poverty level, or $15,800 for a single person and $32,500 for a family of four.
Medicaid is the state-federal program that covers medical bills for the poor. Its expansion is part of the Affordable Care Act (ACA), also known as “Obamacare.”
Under the law, the federal government would pay for nearly all of the expansion costs through 2016, and phase down its support to 90 percent by 2020.
However, a 2012 U.S. Supreme Court decision on the ACA said expanding Medicaid is optional for the states, which will pay for a share of the costs.
A majority of Republicans at the 2013 Montana Legislature voted last April to reject the Medicaid expansion in Montana, prompting supporters to launch the initiative drive.
Yet even if voters approve the expanded eligibility, the 2015 Legislature still would have to authorize spending of the federal and state money, because a voter-initiative cannot authorize spending of public funds.
Opponents of Medicaid expansion in Montana, including Senate Majority Leader Art Wittich, R-Bozeman, have argued that by expanding Medicaid eligibility, the measure essentially spends money and therefore is illegal and should be disqualified.
Fox, a Republican, said last month that an earlier version of the proposal was legally insufficient. He said its effective date of Nov. 4 could be interpreted as authorizing spending before the Legislature met in 2015.
Backers then resubmitted language with an effective date of July 1, 2015, giving the Legislature time to consider the issue.
In a Tuesday letter declaring the new version legally sufficient, Deputy Attorney General Jon Bennion said it could be argued that the new version could authorize spending by next July, without legislative approval.
But to reach that point, backers must get the measure on the ballot, voters must approve it, and the 2015 Legislature must take no action on the issue, he said. If any one of those things doesn’t happen, the issue is moot — and, if they do, the spending still could be challenged then, Bennion said.
This “potential legal infirmity” is beyond the scope of the attorney general’s review at this time, he said, and not ripe for any decision because “many intervening events must first come to pass before the constitutionality of the proposed expansion of Medicaid benefits could be addressed.”