Medicaid Expansion Gains Momentum at Legislature

HELENA – The proposal to expand Medicaid to the working poor gained momentum on Wednesday in the Legislature after some Republicans bucked party leaders who were trying to block the idea.

The Montana Senate endorsed Senate Bill 395 with a 26-24 vote after five Republicans joined the chamber’s 21 Democrats in supporting it. The surprising turn of events came a week after a Republican-led committee rejected the move.

Since then, the Montana Chamber of Commerce, a conservative-leaning business lobby important to some Republicans, has endorsed Medicaid expansion as long as it includes reforms to the system.

Gov. Steve Bullock has continued to use the bully pulpit to highlight support across the state.

Supporters argued that the program takes advantage of money from the federal health care overhaul to provide coverage to as many as 70,000 Montanans who earn less than 138 percent of the poverty level. That is equivalent to about $15,000 for a single person.

State Sen. Dave Wanzenried, D-Missoula, said his bill provides needed help to people who are “one medical checkup away from being bankrupt.”

Conservative Republican Senate leaders opposed the plan, saying the state could eventually be on the hook for a big bill if federal money dries up. They estimate Montana could be paying more than a $100 million per two-year budget cycle by 2020.

Senate President Jeff Essmann of Billings and Senate Majority leader Art Wittich, a Bozeman lawyer, held a midday meeting to lobby their caucus against the bill. Wittich cautioned lawmakers on the floor they had better be prepared to “own your vote.”

But the caucus splintered.

Some Republicans said they would not follow leaders they argued were engaging in gamesmanship.

Sen. Llew Jones, a Conrad businessman, said he was not afraid of political attacks on the matter — a stab at GOP architects of attack mailers. The divisive political strategy continued to drive a wedge in the GOP caucus.

“I am going to take this vote and let the postcards come,” Jones said, challenging Republican Senate leaders.

Several of the Republicans who backed the plan said they want changes to be made in the House, perhaps even a smaller expansion of Medicaid and more reforms. They argued the bill needs to move forward so it can clear a Friday procedural deadline.

State Sen. Taylor Brown, a Huntley Republican who runs a rural Montana radio network, said he wants the bill to survive so a bipartisan “Montana-made solution” can be found. He said constituents want something done.

“They don’t want us to just say no,” Brown said.

Bullock, in a statement, thanked the supporters who acted despite “threats from dark money political groups.”

“I applaud these statesmen and women for their courage,” the governor said.

Support for the program has come from hospitals, medical organizations, business leaders and others. They argue that the influx of federal money will boost the state economy and reduce costs for consumers who are paying more to help cover the unpaid medical bills of the uninsured.

During hearings, opposition has been comparatively small.

The House rejected a move Tuesday to force a vote on a similar plan that’s locked up in a committee. The procedural motion failed to get the necessary 60 votes from among the 100 House members.

Medicaid expansion supporters, however, were able to garner support from a simple majority, when 52 representatives backed the idea — a potentially significant number if the Senate bill hits the chamber.

“Almost every sector of our society has stood up and said we think the expansion of Medicaid is the right thing to do,” said House Democratic Leader Chuck Hunter of Helena.

House Republican leaders did pass a stripped down bill that they argue could be used to tackle the problem without federal money. They said those ideas would be developed later.