HELENA — Advocates said Wednesday that they will be running up a ballot initiative in Montana to bring the question of Medicaid expansion straight to the voters.
The Montana Legislature rejected plans to use federal money to expand Medicaid to those making up to 138 percent of the federal poverty level. A provision of the federal health care law provides the bulk of the money for such expansion.
Many Republicans opposed to implementation of the federal health care law argue the state could eventually be on the hook for the expansion.
On Wednesday, a coalition of health and consumer groups formed a ballot committee called Healthy Montana Initiative to lead the effort to write and qualify an initiative for the ballot. The advocates included organizations like AARP of Montana, the Montana Human Rights Network, the Montana Nurses Association, the Association of Montana Public Health Officials and others.
Advocates said they expect voters will endorse expansion because it focuses on getting health insurance at a low cost for the working poor.
“This is about expanding a program that has helped people in our communities and is effective and cost-efficient at providing health care,” said Kim Abbott, president of the Healthy Montana Initiative.
Abbot said the group will spend the next couple of months finalizing the ballot language. She said it will be the “simplest, clearest” expansion of Medicaid possible. She said compromise measures floated during the Legislature are too complex to be considered for a ballot measure.
Abbot said the Legislature could still call a special session to adopt a compromise plan before the ballot initiative qualifies. Gov. Steve Bullock has backed Medicaid expansion, although he has not said if he would be willing to call a special session to work on it.
“I think the Legislature’s job is different than ours. And it would be a good thing if the Legislature came back to get this done without delay,” Abbot said. “But we don’t control that. So we are going to do our job.”
Abbot said one problem with a ballot measure is that the soonest it could be implemented is late 2014 — nearly a year after the federal health care law requires everyone to have or purchase health insurance.
The Obama administration announced Wednesday that low-income residents in states that decide to opt out of a big Medicaid expansion — such as Montana — in the new health care law will not risk federal penalties as an unintended consequence. It said low-income residents in those states who would have been eligible for the coverage will not face the individual insurance mandate.
Republicans opposed to Medicaid expansion in Montana pointed to the potential long-term costs if the federal government doesn’t keep paying the bulk of the cost. They also pointed to a study suggesting some Medicaid patients didn’t see positive outcomes.
“Long term, the initiative backers do not have a way to pay for this. Worst of all, we could spend all that money to achieve nothing,” said state Sen. Fred Thomas, R-Stevensville. “Why would we put taxpayers on the hook for $250 million or more for a plan that doesn’t achieve better health results?”