Two Republican-backed bills to phase out or modify Montana’s Medicaid expansion for low-income adults failed in the state Senate this week. These outcomes indicate a willingness among lawmakers to continue the joint state-federal program. Montana’s Medicaid expansion, initiated in 2015, covers adults earning below 138% of the federal poverty level, roughly $15,500 for an individual in 2025. Initially renewed in 2019, the expansion is scheduled to sunset unless reauthorized this summer.
Despite bipartisan support, the expansion faced challenges with recent proposals aiming to alter or end it. A bill by Rep. Ed Buttrey, R-Great Falls, cleared the House with bipartisan support and awaits a Senate hearing. However, some Republicans oppose its cost and government involvement, citing the $1 billion annual expense, 90% federally funded, covering over 76,000 Montanans.
Republican Gov. Greg Gianforte supports Medicaid expansion but has not endorsed a particular plan. Two Senate proposals sought differing reforms: one by Sen. Carl Glimm, R-Kila, proposed halting new enrollments, which failed by a 10-vote margin. Another by Sen. Jeremy Trebas, R-Great Falls, suggested resubmitting the expansion for federal approval with added work and premium requirements.
Trebas framed his bill as a way to protect taxpayers and address potential federal funding changes. However, Democrats criticized it as undermining the program. Trebas’ proposal was narrowly defeated, with nine Republicans siding with Democrats. The Senate indefinitely postponed both bills, decreasing their chances of revival this session.
“Pass this so we don’t have to have a special session,” Trebas said, highlighting budget concerns. Meanwhile, Buttrey’s bill, having passed the House, awaits Senate committee scheduling.
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