Medicaid expansion is a “crucial priority” for Democrats in the 2025 Montana Legislature, aiming for more than just continuation. Democratic leaders, including Rep. SJ Howell of Missoula, expressed intentions to enhance the program for seasonal workers to maintain health insurance. “Continuing our current Medicaid program is the most important job that we have, but that is the floor, and we do have a vision for ways we can improve the program,” Howell stated. The expansion, covering nearly 80,000 Montanans, is part of Gov. Greg Gianforte’s budget proposal for the 2027 biennium, but will sunset in June 2025 without legislative action.
In a video news conference, Howell, alongside Rep. Mary Caferro, vice chairperson of appropriations, discussed the governor’s budget and highlighted Medicaid expansion as a priority. Howell appreciated the inclusion of Medicaid in the base budget, while Caferro criticized the recent income tax cuts, claiming they favor the top 20% of earners. She noted that the lowest earners receive minimal benefits from these cuts. Meanwhile, Democrats plan to propose equitable solutions like a child tax credit to support working families and seniors.
Republicans offered up to $675 in property tax rebates for 2022 and 2023, but many eligible individuals did not receive them, and renters were excluded. In response to rising property taxes, Gov. Gianforte convened a task force that delivered proposals for the 2025 legislature. Despite losing their supermajority, Republicans maintain control of the Montana Legislature. Property taxes and Medicaid expansion are anticipated to be key topics of debate.
Medicaid expansion in Montana covers individuals with incomes up to 138% of the federal poverty level, with the federal government covering 90% of costs. Democrats view the program as beneficial for the state’s economy and health, although some Republicans worry about future state obligations. Howell and Caferro believe the program has broad support, including from diverse groups like law enforcement, citing benefits for people in crisis.
Democrats oppose additional restrictions on Medicaid recipients, suggesting that work requirements only add unnecessary “red tape.” Continuous eligibility, previously in place, is advocated by Democrats to support both individuals and providers. This system allows seasonal workers to maintain coverage without frequent eligibility checks, benefiting providers by ensuring timely reimbursements.
Supporters argue Medicaid expansion prevents rural hospital closures, a concern Howell and Caferro echoed, noting no closures in Montana since 2015. They emphasized the importance of the program for community healthcare, with 136 rural hospitals closing nationwide, predominantly in states without Medicaid expansion. “The threat to rural hospitals is real,” Howell asserted.
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