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Nothing short of the governor’s full Medicaid expansion plan makes sense.

Representative Nancy Balance’s partial Medicaid expansion alternative to the governor’s full Medicaid expansion plan suffers the fatal flaw of offering fewer benefits at higher cost. By rejecting the federal tax dollars Montanans have already contributed for Medicaid expansion, her bill would require us to come up with additional state tax dollars to provide benefits to fewer people. No pared-down plan makes sense for potential recipients whose quality of life depends on Medicaid coverage, nor for taxpayers footing the bill (why pay more for less?), nor for community hospitals struggling under the burden of uncompensated care (the less uncompensated care the better), nor for their insured patients to whom uncompensated care costs are shifted (less uncompensated care decreases everyone’s health insurance costs).

I expect that those who oppose full Medicaid expansion because they think it will discourage new beneficiaries from working (in order to maintain Medicaid eligibility) have not personally witnessed how the lack of Medicaid discourages employment. As a long standing member of the YWCA of Helena board of directors, I have witnessed dozens of women transition from unemployed homelessness to employment and housing they can afford. That is a difficult transition, and some of the biggest barriers are untreated physical and mental illness, trauma, brain injuries, post-traumatic stress and addictions. Expanded Medicaid would provide the treatment and medical care that is needed by many broken and dependent members of our community to become successfully employed.

In fact, there would be no incentive for new beneficiaries under the governor’s expanded Medicaid plan to reject work that puts them over the program’s income limits. If their income exceeds the limits, they will be eligible for existing Affordable Care Act, income-based subsidies to buy their own health insurance. Expanded Medicaid for those at the bottom of the income scale in combination with existing federal subsidies for those a little higher up (but not high enough to afford a full health insurance premium) will allow all Montanans to take any job, advance up any career ladder and reach their full economic potential without jeopardizing health care coverage. Full expanded Medicaid will be a bridge to full independence for many.

Editor's note: The Montana House Tuesday officially killed Gov. Steve Bullock’s Medicaid-expansion proposal, refusing on a party-line vote to overturn a committee report to reject it.

Joyce Brown

Helena

The Montana House Tuesday officially killed Gov. Steve Bullock’s Medicaid-expansion proposal, refusing on a party-line vote to overturn a committee report to reject it.

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