NEWS

Waiting for Medicaid costly to some Montanans

Kristen Cates
kcates@greatfallstribune.com
Holly Blouch and her mom before testifying in favor of Medicaid expansion in the Montana Legislature last spring.

Holly Blouch wants to be working, and she wants to be healthy.

But right now, it’s almost impossible to do both.

Diagnosed with carcinoid disorder eight years ago, Blouch needed to work to have health insurance to pay for her medical care, which will some day involve needing a kidney transplant. But she can’t work enough hours to keep medical insurance because of her health.

“There are a lot of people out there like me,” said the 37-year-old Kalispell woman.

She’s referring to herself and the 69,999 other Montanans who now qualify for Medicaid coverage after the Montana Legislature approved the expansion plan this year.

But she’s got to wait a little while longer to get that coverage while the federal government reviews Montana’s waiver application.

State officials are hopeful Montana’s plan, which calls for a third-party administrator to manage the program and requires modest premiums from participants, will be approved by Nov. 1 so those eligible can start applying at the same time the health insurance exchange opens.

“We want to make everything as smooth as we can,” said Mary Dalton, director of Medicaid for the Montana Department of Public Health and Human Services.

But time is of the essence for people like Blouch, who started lobbying for the Medicaid expansion as her kidneys started failing and didn’t have the insurance to get the transplant and now requires dialysis.

“What we’re really emphasizing is a sense of urgency,” said Heather O’Loughlin, co-director of the Montana Budget and Policy Center.

O’Loughlin said there are countless other stories of Montanans who are getting sicker while waiting for the waiver to be approved.

Previously, childless adults 19-64 years old didn’t qualify for Medicaid, Dalton said. But the agreement made in the Montana legislature said people living at 138 percent of the federal poverty level — or making $16,400 per year — now qualified.

Montana’s compromise law made it so that a third-party provider will run the program. Dalton said a recommendation on a provider has been made, but the name of that provider has not yet been released.

Though there are an estimated 70,000 Montanans who qualify, Dalton said the state is expecting approximately 45,000 people signing up. In addition to there being a third-party administrator, participants will have to pay premiums, which can be no greater than 2 percent of their household income.

Olivia Ruitta from the Montana Primary Care Association said the majority of the 70,000 Montanans who qualify for Medicaid are working.

Ruitta said a number of these people are dealing with chronic pain problems and often have to make the choice between what prescriptions they’ll fill each month.

“They are not making enough money to get over that hurdle,” Ruitta said. “Holly is just one of many, many patients we see.”

Blouch had been hoping to get her transplant before needing to go on dialysis. But as more time has passed and other surgeries have become necessary, she can no longer avoid dialysis.

Her medical bills are astronomical, and she’s trying to pay approximately $100 a month. But she can only work 25 hours a week, making a decent $12.50 hour wage.

“There truly are people out there who need it,” Blouch said.

Reach Tribune Staff Writer Kristen Cates at 791-1463. Follow her on Twitter @GFTrib_KCates.