HELENA — The Montana Senate has voted down a bill that would have started phasing out the state’s Medicaid expansion program – a day after the House voted to send a bill renewing the program over to the Senate.
Senate Bill 62, sponsored by Sen. Carl Glimm, R-Kila, failed on a 20-30 vote. 12 Republicans joined all 18 Democrats in voting against it.
(Watch the video to see lawmakers' arguments on the future of Medicaid)
As of November, the Montana Department of Public Health and Human Services reported 76,188 adults were enrolled in the Medicaid expansion program, which directs federal and state funding to support health care for people making less than 138% of the federal poverty level. The program is currently set to expire June 30.
SB 62 would have created what Glimm called a “soft unwind” – allowing those already enrolled to stay on Medicaid expansion as long as they remained eligible, but not letting anyone else join.
Glimm and other supporters pointed to reports that the Trump administration and Republican majorities in Congress are looking at cutting back federal spending on Medicaid. They said, if the federal government merely lowers the 90% match it currently pays for Medicaid expansion, it could put Montana on the hook for millions of dollars more.
“If anybody hasn't been paying attention, things at the federal level have been changing awfully rapidly,” Glimm said. “It has even changed this discussion, because now what we're talking about is block grants for Medicaid. And if that happens, the block grant that will come to the state of Montana will be much reduced in funds – but also it will reduce the number of strings attached to those funds, so we as a state are going to have to figure out where our priorities lie.”
“We can get our state adjusted to the coming reality and plan to become sustainable on our own, or we can live in this fiscal fantasy – and that's really what this is all about,” said Sen. Jeremy Trebas, R-Great Falls.
Opponents of SB 62 said there are safeguards in the bill to ensure that Montana will have a chance to reconsider Medicaid expansion if the federal government does change its level of support.
“There is a lot of volatility right now on the federal level; we don't know what's going to happen,” said Sen. Emma Kerr-Carpenter, D-Billings. “And to me, it seems absurd that we would be making a giant fiscal and policy decision based on a such a volatile environment.”
Sen. Russ Tempel, R-Chester, said renewing Medicaid expansion was key for his rural district.
“We have four hospitals; one of those hospitals works on a 2% margin, is what they're making,” he said. “11% of that comes from Medicaid expansion. Without that, they'd be losing 9%, which is a little over half a million dollars. That hospital employs a little over 120 people. And so without this, not only that hospital, but three or four of those other ones are in trouble.”
The House gave initial approval Friday and final approval Monday to House Bill 245, sponsored by Rep. Ed Buttrey, R-Great Falls – both on 63-37 votes. That bill would remove the June 30 sunset date for Medicaid expansion.
