HELENA – A second Republican-sponsored bill to extend and modify Medicaid expansion in Montana is in the works, with a focus on tightening eligibility for the health-care program and helping recipients out of poverty.
“The eligibility needs to be tightened down,” said Sen. Bob Keenan, R-Bigfork, who’s leading the effort. “We should be looking for results – health results, work results. We’re trying to get people who are eligible for Medicaid expansion and have them graduate from the program.”
Keenan’s proposal, yet to be drafted, will become the second GOP bill and third measure overall addressing one of the biggest issues of the 2019 Legislature: How to continue Medicaid expansion, which currently provides government-funded health coverage to 95,000 low-income adults in the state.
The three-year-old program, funded mostly by the federal government but requiring approval by the state Legislature, is set to expire in June.
Democratic Rep. Mary Caferro, D-Helena, has already introduced House Bill 425, to extend Medicaid expansion in its current form. She says the program is working well and doesn’t need any significant changes.
But Republicans, who control majorities at the Legislature, have said they want to modify the program and make it harder to qualify for its virtually free coverage.
The Medicaid coverage is open to childless adults who earn up to 138 percent of the federal poverty level, or about $16,700 a year for a single person.
Rep. Ed Buttrey, R-Great Falls, who sponsored the bill that authorized Medicaid expansion four years ago, is preparing a bill that’s expected to add some requirements for eligibility, such as work hours or drug-testing.
Keenan told MTN News Wednesday that he’d like to see work requirements as well, such as those in place for other welfare programs in Montana, but that he’s not sure they’ll be in his proposal.
“I’m going through the process right now of whether I want to put something in that’s going to end up being a third rail, and cause a big emotional upheaval over that,” he said.
What will be in his proposal, however, are requirements for the state to check more closely on program applicants’ residency and income levels. Right now, the state isn’t doing enough to verify those items, he said.
“There is no question that Medicaid expansion has done some good,” Keenan said. “What I’m trying to do is put some guard rails on it.”
Buttrey said Wednesday he’s still putting the final touches on his bill, and that he believes it will address many of the concerns raised by Keenan and other Senate Republicans.
Democratic Gov. Steve Bullock, a big supporter of Medicaid expansion, has spoken out against work requirements or any other restrictions that he says will be too costly to administer.
When asked Wednesday what restrictions he might find acceptable, Bullock was noncommittal.
“I certainly want to take a look at all of the ideas out there, and not drawing any lines in the sand, by any measure, but let’s actually make sure we’re working together to try to improve it, not set it back,” he said.
Keenan said he’ll refine his proposal in the coming weeks, and that he’s not sure who will sponsor the bill or whether it will start in the Senate or House.
The House Human Services Committee has already scheduled a March 16 hearing date for the Medicaid-expansion bills sponsored by Caferro and Buttrey.