In Montana, Medicaid expansion significantly improved healthcare access for low-income residents, especially on reservations. The Montana Legislature’s decision to adopt the program ensured health insurance for adults earning up to 133% of the federal poverty level. As of June 2024, Medicaid covered nearly 230,000 Montanans, including 81,000 under the expansion group. This initiative notably enhanced healthcare availability on reservations, where funding shortages previously limited access.
Aaron Wernham, CEO of the Montana Healthcare Foundation, highlighted that Medicaid expansion improved healthcare access and outcomes while reducing costs. The program allowed the Indian Health Service to extend budgets, enabling preventive care rather than just emergency services. This shift also benefited those not directly under Medicaid but living on reservations.
Economists praised the program as a cost-effective economic development tool. Despite the success, Medicaid expansion’s future is uncertain, as it is part of Gov. Greg Gianforte’s budget proposal, set to expire in June 2025. KFF Health News noted a “trigger law” could end the program if federal funding is cut by a Republican-led government.
While conservative groups argue the program’s cost is excessive, they claim it benefits the healthcare industry more than patients. Yet, a recent webinar by the Montana Healthcare Foundation showcased the program’s extensive reach and fiscal advantages. In some counties, over half the population is covered by Medicaid, impacting areas including the Blackfeet, Fort Peck, and Crow Indian Reservations.
In the 2023 fiscal year, Medicaid costs in Montana amounted to $2.4 billion, with the federal government covering 79%. Despite covering more individuals, state general fund spending has remained stable, thanks partly to the cost-sharing structure where the state pays just 10% for expansion versus 35% for traditional Medicaid.
The expansion reduced the uninsured rate from 16.4% in 2015 to 11.4% in 2022. Increased screenings for breast cancer, diabetes, and cholesterol reflect the program’s health impact. Federal contributions also boosted Montana’s economy, creating thousands of jobs and generating significant income and economic activity.
Medicaid expansion created jobs at minimal cost, contrasting typical state-funded economic development programs. However, potential federal funding cuts could leave millions uninsured, particularly those earning too much for traditional Medicaid but too little for marketplace subsidies.
Montana’s law mandates a rollback if federal funding drops below 90% unless alternative funding is secured. The traditional Medicaid federal match averages 57%, underscoring the importance of maintaining current expansion support.
MT Media Webinar_12.12.24 FINAL
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