HELENA — A Republican-led committee allowed nearly three hours of testimony in favor of a proposal to expand Medicaid to about 70,000 low-income Montanans before voting along party lines to give the bill an unfavorable report.
Many of the more than 200 supporters present spoke for and about a dozen people spoke against House Bill 249 known as the “Healthy Montana Plan” in a hearing that lasted 6½ hours Friday night.
Ten Republicans voted for and seven Democrats against a motion in the House Human Services Committee to pass the measure to the House floor with a recommendation that representatives vote against it.
“To have that outcome is really disappointing,” Democratic Rep. Jenny Eck said after the committee adjourned. “Just the disparity between all the supporters and such little opposition and then to have that not recognized in the vote is frustrating.”
Democratic Gov. Steve Bullock, who has been pushing the proposal since 2013, has said Montana must make health insurance available for those who struggle to make ends meet.
“I am not done working on this and my door remains open to legislators willing to find real solutions for the 70,000 Montanans that are counting on them,” Bullock said in a statement after the hearing.
Tara Veazey, health policy adviser to the governor, said during the marathon hearing that the health and lives of some Montanans hung in the balance.
“It’s rare in this building that moral policy, fiscal and economic imperatives all align,” Veazey said in support of the bill. “This is one such instance.”
Bullock’s office estimates that about 70,000 people fall into a coverage gap in which they don’t currently qualify for Medicaid or for subsidies to help them pay for coverage on the federal health care exchange. Under the measure, adults making up to $16,242 a year and a family of four earning up to $33,465 would become eligible for Medicaid.
Holly Bouch now falls into the gap after losing her job and health insurance in September. She’s been diagnosed with a chronic lung disorder that spread and attacked her kidneys and liver. After she lost her insurance, she also lost her place on the kidney transplant waiting list. She works part time, but her lung condition makes it difficult to find the full-time work and benefits she needs to be considered for a transplant.
“Medicaid would allow me to get back on the transplant list and could afford my medication and be able to see my doctors on a more frequent basis,” Bouch said. “Medicaid expansion would give me a shot at a normal, healthy life.”
Numerous proponents, including Bouch, were too sick to stay at the hearing after they spoke.
Mark Semmens, managing director of investment banking for D.A. Davidson Co. in Great Falls, said as someone who has spent 30 years immersed in business, finance and economic issues that lawmakers need to look beyond ideology and at the numbers.
Semmens said the expansion would bring an estimated $5 billion of new revenue into Montana over the next 6 years and create 12,000 jobs.
As originally enacted, the Affordable Care Act required states to expand Medicaid to adults earning up to 138 percent of the federal poverty level. A U.S. Supreme Court decision in 2012 made the expansion optional for states but kept a financial incentive in place.
The federal government will fully fund the expansion until 2020, after which states will be responsible for 10 percent of the costs. The expansion is projected to save the state of Montana $80 million in the four years leading up to that cost sharing.
The Republican-led Legislature rejected expansion in 2013 and this year cited concerns about covering people they say are “able-bodied” and sticking the state with the costs if federal money dries up.
Those speaking in opposition included Americans for Prosperity Montana, an organization of the political network backed by industrialist billionaires Charles and David Koch. This week the group launched television and radio ads against the expansion and announced a website highlighting Republican lawmakers they say are considering voting for Medicaid expansion.
“Government health care is not the solution on any level,” John Quandt, executive director of AFP Montana, said.
Republican lawmakers have proposed their own plan that would cover only about 10,000 people including some veterans and low-income parents, plus about 800 disabled people who qualify for services but are on long waiting lists to get care. The measure would cost the state more than $20 million annually. That bill is advancing in the House.