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Republican sponsor preparing Medicaid-expansion bill; gov renews pitch

HELENA – As Democratic Gov. Steve Bullock made a new pitch Tuesday for extending Montana’s $550 million-a-year Medicaid expansion program, a leading Republican told MTN News that he’s hoping to introduce a Medicaid bill in the coming weeks.

But Rep. Ed Buttrey of Great Falls, who sponsored the original Medicaid-expansion bill in 2015, said his proposal will make some changes in the program that provides government-funded health coverage to nearly 100,000 low-income Montanans.

“The program has worked exceptionally well; it’s saved the taxpayers and the state of Montana a lot of money,” he said. “But it does need to be reformed.”

Rep. Ed Buttrey, R-Great Falls

The Bullock administration, a big supporter of expanded Medicaid, may introduce its own bill to extend the program, which is set to expire June 30.

Yet with Republicans in control of both houses of the Legislature, Buttrey’s bill is probably the Medicaid measure to watch at the 2019 Legislature.

Buttrey said his bill will be called the Medicaid Reform and Integrity Act.

He told MTN News in an interview Tuesday that he wants all parties benefiting from the program, from patients to health-care providers, to have “skin in the game” to help pay the state’s share of the costs.

Buttrey said Republicans want to ensure that taxpayers don’t get stuck paying more costs for the program and that those covered by the program are “truly needy.”

“We need to make sure that we’re serving the people who truly need it the most and are willing to contribute to their own health and well-being,” he said. “So we’re not trying to implement provisions to necessarily take a whole bunch of people off the program. …

“It’s all about making everyone accountable to be part of the program, to be performing, and I think we’ll have a good solution and I hope it’s a bipartisan one.”

At a Capitol news conference Tuesday, Bullock unveiled a new report by his administration showing how Medicaid expansion is covering employees at thousands of businesses across the state.

“I think it’s time that we finally fully recognize that the value of Medicaid expansion is as much for Montana businesses as it is for Montanans who receive health care,” he said.

Expanded Medicaid pays the health-care bills for Montana adults earning up to 138 percent of the federal poverty level, or about $16,700 a year for a single person.

The federal government covers 90 percent of the costs, while the state must pay the remainder, estimated at $60 million a year over the next two years.

The report said nearly 18,000 businesses in Montana, from small businesses to large, employed at least one person covered by Medicaid expansion in 2017.

The effects also weren’t limited to any one area or type of area of the state. For example, six in 10 businesses in the urban counties of Cascade, Flathead and Missoula had employees covered by Medicaid expansion, and nearly 92 percent of the businesses in rural Golden Valley county employed people on the program.

Bullock said 37 percent of Montana businesses don’t offer health coverage to their employees – and that if businesses had to insure all of their employees covered by Medicaid expansion, the cost would be anywhere from $353 million to $940 million in 2017.

“Businesses are truly the backbone, certainly, of Montana’s economy – businesses and the workers at those places,” he said. “The report clearly shows that businesses, large and small, benefit from and rely upon keeping Medicaid expansion.”

Mike Dennison

Mike Dennison

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