This spring marks the 10-year anniversary of Healthy Montana Kids. Until 2009, tens of thousands of Montana children had no health coverage; no way for their families to pay for a doctor visit or a hospital stay. Montana families, working to make ends meet, were one childhood medical emergency away from bankruptcy — praying every day that their son or daughter would not get sick. I met hundreds of these families face to face and saw first-hand their stress, their frustration and their tears.
Time after time, the Montana Legislature defeated measures to fix this problem. Eligibility for the Children’s Health Insurance Program was capped at 165 percent of the federal poverty level — about $30,000 combined household income for a family of four. In 2003 and 2005, the Legislature killed bills to raise the cap to 200 percent. In 2007, the Legislature barely allowed an increase to 175 percent. Tens of thousands of kids remained uninsured.
In 2008, Montanans were fed up, and I-155 was born. I-155 combined the CHIP program and children’s Medicaid behind a new home-grown storefront called "Healthy Montana Kids." HMK increased CHIP eligibility to 250 percent of the federal poverty level and allowed Medicaid to enroll kids up to 185 percent. It eliminated the asset test for kids, simplified the application and allowed hospitals and schools and other enrollment partners to sign kids up under streamlined presumptive eligibility guidelines. All of this was done without a tax increase, using existing premium tax and federal matching funds. In November 2008, Montanans passed I-155 by a vote of 70 percent to 30 percent. That is what we call a landslide.
Ten years ago, a pitched battle was fought in the Legislature between those who wanted to honor the will of Montana voters and those who did not. Fortunately, this time, thanks to the loud voice of the people, the opposition backed down and our kids won.
Healthy Montana Kids has become part of the landscape of Montana. Former DPHHS official Mary Dalton called it “probably the most universally popular program that I’ve ever been associated with.” For Jamie Newman, who gathered signatures for I-155, it meant being able to take her daughter Charlotte to the doctor for checkups. For Maarten Fisher, it meant getting his son Sam’s broken leg fixed without crippling medical bills. For Brie Oliver, who is now the director of Healthy Mothers, Healthy Babies, HMK allowed her 3-year-old daughter Jillian to have a tonsillectomy that “literally changed her life” and provided a temporary bridge while Jillian’s dad finished his schooling, started a new job and the family achieved financial stability.
The list of life changing stories is long. Sixty-thousand more children have been covered as a result of I-155 and more than half of Montana kids now get their health coverage through HMK. These healthier kids learn better in school and reduce infectious illnesses — which makes our schools safer and more productive for everyone. And nearly $700 million in federal funds has been drawn into our local economies.
HMK also helped pave the way for “Medicaid expansion” by nearly completing the children’s part of the expansion while showing providers, patients and lawmakers the value of this coverage to our families and communities.
So, as folks up at the Capitol grapple with the finer points of renewing Montana’s health care expansion, it is time to raise our hands and voices again to remind them of what we did and why we did it. Join us, if you can, in the old Supreme Court Chambers of the Montana Capitol, April 4, 2019, to celebrate the 10-year anniversary of our baby — Healthy Montana Kids.
Former State Auditor John Morrison wrote Initiative 155 and led the campaign to pass it. A founder of Healthy Montana Kids, Insure Montana and the Montana Health CO-OP, Morrison is now a trial attorney in Helena.