Medicaid expansion bill still on ice

Posted at 2:12 PM, Apr 13, 2019
and last updated 2019-04-15 16:24:33-04

HELENA — For the third consecutive day, Senate Republicans on Saturday blocked the bill to continue Montana’s Medicaid expansion program — with no specific indication on how the stalemate over the health-care bill might break.

The 26-24 vote Saturday against debating House Bill 658 means the Senate has only one more day — Monday — to pass the measure before it would need a supermajority vote to advance, because of legislative deadlines for moving it to the House.

Senate Majority Leader Fred Thomas, R-Stevensville, told reporters Saturday that GOP senators still need time to examine fiscal impacts for the $700 million-a-year bill, which provides health coverage to 96,000 low-income adults in Montana.

But he also said its passage may be tied to the prospects for a number of Republican-favored bills, including a measure affecting a Colstrip coal-fired power plant.

“We’re trying to make sure the state’s economy moves forward,” he said after Saturday’s Senate floor session.

Senate Minority Leader Jon Sesso, D-Butte, asked for the vote to Saturday to schedule HB658, the Medicaid expansion bill, for debate and another vote. The result was the same as Friday: A 24-26 defeat, with all 26 “no” votes from Republicans.

HB658 remains in legislative limbo before the Senate, after senators deadlocked Thursday, 25-25, on whether to advance the bill.

Sesso said after the floor session Saturday that he’s hopeful the bill will be debated Monday. The handful of Republicans who are co-sponsors of HB658 but who have been voting against it have told him “to be patient and that they’ll be supportive and they will not let Medicaid fail,” he said.

But a key transmittal deadline for the bill is approaching. If HB658 isn’t approved by the Senate on Monday, a super-majority of at least one house would be required to advance it to the House, where it needs to have another vote, because it’s been amended.

“We don’t want to create a super-majority vote in either house,” Sesso said.

When asked if he had an assurance from some Republicans that they would eventually support the bill, Sesso replied: “I had an assurance that it was going to pass on Thursday. … I feel a little bit like the groundhog, at this point.”

Thomas said he didn’t think the deadline was a deal-breaker.

“Rules can be changed, rules can be suspended,” he said. “Bills can be brought back to life. There are all kinds of things that can happen in the legislative process.”

Medicaid expansion in Montana is scheduled to expire June 30, unless the Legislature re-authorizes it. The program, funded 90 percent by the federal government, provides health coverage to adults earning up to 138 percent of the federal poverty level, an income level of about $17,200 a year for a single person.

About 90 percent of the people on the program earn less than 100 percent of the poverty level.

HB658 would continue the program, but adds some new eligibility requirements, including that some enrollees complete 80 hours a month of “community engagement,” which could be a job, volunteer work, drug treatment or time as a student.

The House approved the measure last month on a 61-37 vote, but the measure has stalled in the Senate, after reaching the Senate floor this week.

A handful of moderate Republican senators who co-sponsored the bill have been voting against it, saying they want assurances from Democrats and Gov. Steve Bullock that some unrelated measures that they support will pass.

Chief among those proposals is Senate Bill 331, which would help NorthWestern Energy buy a portion of the Colstrip 4 power plant and a high-voltage power line — a move that supporters say will help prolong the life of the coal-fired plant and generally help the state’s energy developers and consumers.

SB331 passed out of a House committee Friday evening, but not before being substantially amended.

Thomas said Saturday that Republicans are still saying that bill needs to pass, but then he mentioned several other bills that the GOP believes are important, and that could be part of the end-game discussions at the Legislature, including bills on tax credits for businesses hiring certain employees, water rights and extending coal leases in southeastern Montana.