Speaker of the House Mark Blasdel, R-Somers, and Senate President Jeff Essmann, R-Billings, are unlikely to let Montana expand access to free federal health care for nearly 70,000 Montanans.
The federal Affordable Care Act budgeted free Medicaid health insurance expansion to all citizens with incomes of less than $15,400 annually. The catch being that the U.S. Supreme Court mandated that state Legislatures must ratify the expansion.
Gov. Steve Bullock has traveled the state promoting Access Health Montana. Bullock said, “It is estimated that Medicaid expansion would bring $750 million in federal support to Montana over the next two years. Roughly 5,000 new jobs in health care related fields would also be created.”
At last week’s health care hearings in Helena, the Association of American Retired Persons said that 15,000 Montanans between the ages of 50 and 64 would be covered under the proposal. Testimony indicated that Medicaid expansion would create more jobs in Montana than the total existing mining and timber jobs combined.
Supporters of health care expansion outnumbered opponents by a 10 to one margin at the hearing. Current lieutenant governor and former adjutant general of the Montana National Guard John Walsh testified that Medicaid could provide health insurance for thousands of military veterans transitioning back to civilian life from years of wars.
Montana House Republicans passed a separate bill spending $400,000 of state general fund money to study health care for two more years. The House assigned a GOP-controlled committee to spearhead the effort.
Apparently, the GOP is still politically hedging that they can transform Montana Medicaid into a state-run voucher program, where a vastly smaller and select group of people use federal dollars to purchase private insurance on the open market.
But since Medicaid is consistently less expensive than private insurance, the GOP’s two-year study will prove an unworkable waste of time and shortchange citizens who now lost two years of federal health care money.
Montana doctors, business leaders and citizens are becoming increasingly frustrated as the biggest job-creating, economy-boosting and lifesaving bill simply flounders in a GOP-controlled Legislature. Medicaid expansion was introducesdbefore Valentine’s Day.
Given the rigid opposition from Speaker Blasdel and President Essmann, Medicaid may not expand in Montana. Enough moderate Republicans would have to stand together and politically “roll” leadership. But the stakes could not be bigger for Montanans.
All major policy decisions occur in the closing days of the session. Republicans control the Montana Legislature and the parliamentary rules. The GOP has the votes to stop billions of federal dollars from being invested in Montana. But in Helena time, there are a lot of legislative days left in this session to expand Medicaid.
Fresh from Easter break, lawmakers could be faced with an amendment from the executive branch putting Medicaid directly onto the House and Senate floors for a vote. Lawmakers could also be called back into a special session unless they act.
Seventy percent of Montana voters endorsed the Children’s Health Insurance Program in a past ballot measure. Today, two-thirds of Montana Medicaid enrollees are children and elderly.
Community hospitals, charitable organizations and existing health insurance policy holders currently subsidize hundreds of millions of dollars in statewide health care for people without insurance.
Last year Whitefish’s hospital reported $19 million in unpaid services for patients. Kalispell’s hospital provided $38 million and Billings’ hospitals delivered $28 million in unpaid care.
Bullock met with local Flathead leaders last month. Kalispell Mayor Tammi Fisher reportedly said that she was one of the original naysayers to the federal health care law. But like most hometown realists Fisher demonstrated that the time for political acrimony is over by saying, “Go get the dollars.”