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Montana Medicaid expansion bill moves to full Senate

Montana Medicaid expansion bill moves to full Senate

The Montana Senate

The Montana Senate gathers during the 2019 legislative session.

A bill to continue Montana's Medicaid expansion program is moving to the Senate floor after a hearing Monday by the Senate Finance and Claims Committee.

Committee members voted 10-9 to move the bill after discussing its cost and eliminating a proposed funding source.

The sponsor, Republican Rep. Ed Buttrey, asked to remove a tax on workers compensation insurance premiums on policies sold by the Montana State Fund. He instead proposed increasing a tax on hospital outpatient revenue that is being used to leverage more federal funding for the program.

The committee approved the amendment before endorsing the bill. It is not clear when it will be heard by the full Senate.

Buttrey's bill would continue the Medicaid expansion program that covers about 96,000 low-income residents while also adding a work requirement and an improved asset test.

Supporters say the program helps recipients receive preventative medical care rather than more costly emergency care while opponents argue its cost is not sustainable due to federal deficit spending.

The Senate Public Health, Welfare and Safety Committee tabled the bill on Friday. Hours later, the full Senate voted to move it to Finance and Claims for a hearing.

The fiscal note assumes about 4,000 people will lose coverage due to the requirement that recipients work, go to school or meet other community engagement requirements for 80 hours a month. It estimates the state will have to hire about two dozen people to implement and monitor the additional eligibility requirements.

The governor's budget office also estimates the enhanced asset test will result in a premium increase of an average of $240 a month for 64 recipients if they choose to remain on Medicaid expansion. Hutterite colonies have also agreed to pay the state's share of the costs of their 2,500 members who are covered under Medicaid expansion.

Republican Rep. Bob Keenan asked numerous questions about the program's cost, funding and oversight and said he respects what the program has accomplished, but expressed frustration that it seemed like the Senate had been asked not to amend the bill, which has already passed the House.

"I've never seen so much resistance to the Senate amending a bill, changing it, maybe making it better," Keenan said. He said he planned to offer amendments on the Senate floor and voted against the bill after Monday's hearing "mostly because of the process."


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