Support Medicaid Expansion

The Montana legislature has at hand the future of Medicaid expansion. The current program, which was approved by the legislature in 2015, will sunset by the end of 2019. An attempt was made in 2018 to fund the state's share of expanded Medicaid funding through an increase in the tobacco tax by way of a ballot initiative. That initiative was narrowly defeated.

The legislature has before it for consideration HB 658, sponsored by Republican representative Ed Buttery, which would lift the sunset and fund Medicaid expansion. This is the preferred process for crafting a program to fund Medicaid expansion as it allows for debate and compromise. My support for Medicaid expansion in Montana is based on the following points that I would like my fellow Montanans to understand.

Medicaid expansion is funded by a combination of federal and state dollars. Presently, the state of Montana funds seven percent of the cost of the program. That seven percent investment is met with a 93 percent match of federal funding. If Montana does not continue the program that 93 percent match of federal funding will be distributed to other states. The program is an opportunity to keep a portion of our federal tax dollars in our state as we receive funding generated across the nation. If we discontinue the program not only do our tax dollars leave the state, but we lose the much greater portion of Medicaid funding which is generated outside of Montana. There is a component of the current program which guarantees that the state will not be forced to fund any more than 10 percent of the program. If the federal match should drop below 90 percent the program would be eliminated. When the federal match decreases to 90 percent a portion of the difference will be made up by applying funds generated from the hospital and outpatient utilization fees which would offset a portion of the increased cost to the state.

Medicaid expansion has resulted in a decrease in uncompensated care. Should HB 658 fail to propagate Medicaid expansion, uncompensated care rates will climb for hospitals in Montana. As a result, healthcare costs will increase for all Montanans as hospitals are forced to adjust rates of all patients to fill the compensation gap left by the sunset of Medicaid expansion.

In absence of Medicaid expansion some of those covered would qualify for and revert to traditional Medicaid coverage. Compensation rates are not as beneficial to the state under traditional Medicaid as they are under expanded Medicaid. The added cost to the state in funding traditional Medicaid recipients is yet another piece in the fiscal puzzle which validates continuing expanded Medicaid coverage.

Under the current program patients have proven to seek covered preventative care and screenings. Preventative medicine saves lives, and in the long run dramatically reduces cost to the program by catching conditions before they have progressed into full blown illness.

The economic benefits and the health benefits associated with Medicaid expansion are clear. By providing the expanded coverage to a portion of our population, the cost of healthcare is lower for all Montanans and we Montanans are a healthier population.

Please contact your local legislators and the House Human Services committee and urge their support of HB 658 and Medicaid expansion.

Dirk Monson,

Glasgow, Mont.