Medicaid expansion bill advances to MT Senate floor

Posted at 12:43 PM, Apr 08, 2019
and last updated 2019-04-08 16:16:43-04

HELENA — On a 10-9 vote, a state Senate committee Monday advanced one of the 2019 Legislature’s biggest bills to the Senate floor: House Bill 658, which would continue Medicaid expansion, the $700 million-a-year program that provides medical coverage to 95,000 low-income Montanans.

Three Republicans joined all seven Democratic members of the Senate Finance and Claims Committee in support of the bill, which had been transferred the panel last Friday after it was tied up in another committee.

HB658 will be on the Senate floor later this week, where it’s expected to pass and continue on a path to the desk of Democratic Gov. Steve Bullock, who has indicated that he supports it.

Medicaid expansion provides government-funded coverage to adults ages 19-64 and who earn up to 138 percent of the federal poverty level, or about $17,200 a year for a single person. The federal government pays 90 percent of the program’s cost.

The program began in Montana in 2016, but has a June 30 expiration date unless the Legislature reauthorizes it.

HB658 would erase that expiration date, but adds some additional eligibility requirements for the program — including 80 hours a month of “community engagement,” which could be a job, volunteer work, or other activities. However, supporters of the bill have said large sectors of the covered population would be exempt from that requirement.

Whether to continue Medicaid expansion started the session as perhaps the biggest issue of the 2019 Legislature, but now appears to be resolved. The House approved HB658 on March 30 on a 61-37 vote and the Senate also is expected to approve the bill.

Before approving the measure Monday, the Senate Finance and Claims Committee amended it, removing a new tax on workers’ compensation insurance for businesses covered by the Montana State Fund. To make up for the lost revenue, the amendment also increased a tax on hospital outpatient services from 0.825 percent 0.9 percent.

Sen. Bob Keenan, R-Bigfork, who voted “no” on the bill Monday, said he recognizes the good things the bill has done for Native Americans’ health care, but that he felt opponents of the bill have been prevented from adding any amendments they believed would improve the program.

Yet Senate Minority Leader Jon Sesso, D-Butte, said Democrats and supporters of the program had made many concessions in HB658, and that he felt the process had been fair and open.

Last Friday, Republicans on the Senate Public Health Committee voted to table HB658. Hours later, the full Senate transferred the bill to the Senate Finance and Claims Committee, which had a hearing on the finances of the bill Monday morning.

Republican Sens. Mike Cuffe of Eureka, Duane Ankney of Colstrip and Dan Salomon of Ronan voted with the seven Democrats on the Finance and Claims Committee to approve HB658 on Monday.