Article Summary –
Montana’s Medicaid expansion program, which provides coverage for low-income individuals aged 19 to 64, is set to expire in 2025 unless renewed by the state legislature. The renewal is uncertain and expected to be contentious due to political tensions in the upcoming legislative session, which will also address other major issues like property tax laws and housing. If not renewed, the state could see an increase in uninsured individuals, leading to higher healthcare costs as more people rely on emergency room care for untreated conditions.
MISSOULA — Montana’s Medicaid expansion program is set to expire in 2025 unless renewed by the state legislature, with its future uncertain amid a potentially busy session.
State Sen. Steve Fitzpatrick, the Republican majority leader, warned that Medicaid might be entangled with other politicized issues next year.
“It’s going to be hot and controversial,” he said. “And this is going to be a hot and controversial session. This is going to be a rough session.”
Fitzpatrick participated in a panel discussion at Free Press Fest, organized by Montana Free Press, Friday at the University of Montana. The panel included Benefis Health System CEO John Goodnow, state Rep. SJ Howell, D-Missoula, and Cindy Stergar, CEO of the Montana Primary Care Association, with MTFP reporter Mara Silvers as moderator.
Montana legislators first passed Medicaid expansion in 2015 and narrowly renewed it in 2019. Goodnow said hospitals, heavily reliant on Medicaid revenue, were “very concerned” about the renewal’s potential failure in 2019.
With over 100,000 enrollees at its peak, Medicaid expansion covers low-income earners aged 19 to 64. The program, managed by the Montana Department of Public Health and Human Services, benefits from a 90% federal funding match.
Without Medicaid expansion, most recipients would become uninsured, leading to increased overall costs. Goodnow noted that, before the 2015 expansion, uninsured adults often delayed care until symptoms worsened, ultimately seeking expensive emergency room treatments.
“So what they usually will end up doing is waiting way longer than they should to seek out care,” he said. “And then they go to the most expensive part of the health care system, which are emergency rooms.”
Fitzpatrick indicated that Medicaid renewal might pass by a narrow margin in the Senate. He highlighted that multiple major issues like property tax laws, housing, and child care, set for the 2025 session, could lead to challenging negotiations.
The fall ballot measure CI-126 could also impact legislative decisions. The initiative, which seeks to eliminate party primaries and send the top four candidates to the general election, might influence how legislators vote on controversial bills.
“It’s like throwing a stick of plutonium in the building,” he said. “That thing is radioactive.”
Howell acknowledged the potential for heated debates but emphasized Medicaid’s integration into the healthcare system over the past decade, making it difficult to unravel.
“So much of that work and investments that are being promoted really rely on people having health coverage and being able to access that care, and most of that comes down to Medicaid,” Howell said.
Howell also referenced Gov. Greg Gianforte’s HEART Initiative, which focuses on health care in criminal justice and behavioral health. The state secured Medicaid waivers to support services under the initiative.
With the composition of the Montana Legislature still undetermined, Medicaid expansion faces a challenging path ahead.
“But the nuances of how this will play out, I think we’re all eager to see how that will unfold,” Howell said.
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