Buttrey: Court order striking down Medicaid work requirements shouldn’t affect Montana

Posted at 5:59 PM, Mar 28, 2019
and last updated 2019-03-28 20:17:12-04

HELENA — A federal court order this week that struck down work requirements for Medicaid participants in Kentucky and Arkansas shouldn’t affect the debate in Montana over similar requirements, the sponsor of a the bill to add them to Montana’s program told MTN News Thursday.

“We ultimately are going to wait for disposition from likely (the U.S. Supreme Court),” said Rep. Ed Buttrey, R-Great Falls. “While those decisions (Wednesday) affect the work requirements in those individual states, they don’t extend to any other states.”

U.S. District Judge James Boasberg of Washington, D.C., ruled Wednesday that the Trump administration’s approval of work requirements for Kentucky’s and Arkansas’s Medicaid expansion program was “arbitrary and capricious.”

He said modifications to Medicaid are supposed to advance its main purpose of providing medical care to the poor, and that the Trump administration’s rationale demonstrated no such thing. Boasberg invalidated the requirements for both states.

In Montana, where Medicaid expansion covers 96,000 low-income adults, Buttrey is sponsoring a bill that would extend the program past June 30, when the program will expire unless the Legislature reauthorizes it.

His House Bill 658, scheduled for debate on the House floor Friday, makes some substantial changes to the program, including a new requirement that participants must have 80 hours a month of “community engagement,” which could be a job, worker training, attending college, volunteer work or drug treatment.

The “community engagement” requirements in Buttrey’s bill are very similar to the requirements struck down Wednesday by Boasberg’s ruling.

While Buttrey said those rulings don’t apply to anything in Montana, he acknowledged that if his bill passes, the new requirements could be challenged by a lawsuit. If that lawsuit succeeds and the requirements are blocked by a federal court, Medicaid expansion in Montana would continue in its current form, he said.

The bill also includes language that says if the work requirements are not approved by the federal government or somehow invalidated, the program will expire in 2025.

“We put that at six years, because in talking to the folks in the legal community, it’s likely going to be four to five years before the Supreme Court makes a final determination,” Buttrey said.

If the bill passes, Montana also will have to ask the Trump administration for approval of its “community engagement” requirements and other changes to the program.

Buttrey said that approval likely wouldn’t happen until the end of the year — but that he’s fairly confident it will happen.

“All indication from the feds is that CMS (the Center for Medicaid and Medicare Services) is going to continue to approve work-requirement waivers, and, again, everyone needs to really wait for the appeals process and find out what the final court determination’s going to be,” he said.

Democratic Gov. Steve Bullock has stated his opposition to work requirements for Medicaid-expansion participants, but his office has worked with Buttrey to craft a bill that’s acceptable to Democrats and enough Republicans to get it through the Legislature.

This week in the House Human Services Committee, all eight Democrats joined three Republicans to report the bill to the House floor.