Medicaid expansion on way to governor's desk

HELENA - Saturday morning the Montana Senate gave final approval to Medicaid expansion with a 28-21 vote.

The bill, sponsored by Sen. Ed Buttrey, R-Great Falls, now heads to the governor's desk.

Gov. Steve Bullock praised passage of Buttrey's HELP (Montana Health and Economic Livelihood Partnership) Act He said the partisan fighting that sank the bill during the 2013 session threatened to do so again but "Democrats and responsible Republicans stuck together and shepherded the bill to final passage."

Montana will be the 30th state to expand Medicaid eligibility to people making up to 138 percent of the federal poverty level, an income of up to $16,105 a year.

Buttrey called it a compromise because it would require enrollees to pay premiums and copays for services.

They also would be asked to participate in a workplace-assessment survey designed to help them get better-paying jobs. The focus would be on existing job needs and new health care jobs created through Medicaid expansion.

Fees also would be charged to people found to have hidden assets in order to qualify for coverage. An oversight committee would collect data on the efficiency and quality of the health care delivered and to make improvement recommendations to the Legislature. The bill would sunset in four years, allowing the Legislature to renew it if it's working, Buttrey has said.

While Bullock's bill was closer to straight Medicaid expansion, Buttrey's proposal would need a federal waiver in order to implement the expansion because of the additional stipulations. A handful of states have received similar waivers.

Buttrey also estimates that because people would have to pay premiums, fewer would sign up than under the governor's plan. He has said approximately 45,000 Montanans of about 70,000 who would become eligible would enroll in Medicaid under his bill.

The Montana Healthy Campaign, a coalition of several organizations — including Montana Women Vote, Montana Primary Care Association, AARP-Montana, Montana Human Rights Network, SEIU 775 and the American Cancer Society — praised the Senate vote.

They said over the past few months, more than 10,000 people called and emailed into the Capitol switchboard in support of Medicaid expansion. More than 150 people submitted an opinion editorial or letter to the editor. More than 300 signed in or testified in support, and hundreds more came to Helena to attend a rally or talked to legislators.

"We are proud that this legislation was supported by a bipartisan coalition of Legislators from across the state, and we are proud that we are moving forward on this critical issue," the group said in a prepared statement.

Bullock called it a lifeline for rural hospitals.

"It is a historic day," he said. "When we work together, we make Montana a better place."

This story is Tribune Staff Writer Kristen Inbody and the Associated Press. Have questions on Medicaid expansion and how it may affect you or your neighbors? Let us know. Send your questions to kinbody@greatfallstribune.com, and we'll do a Q&A addressing reader concerns.