Supporters of MT Medicaid expansion mull ballot measure to extend it past 2019

Posted at 3:45 PM, Feb 09, 2018
and last updated 2018-02-09 17:45:10-05

HELENA – Supporters of the state’s expanded Medicaid coverage for 91,000 Montanans, set to expire in mid-2019 unless the Legislature extends it, are mulling whether to run a voter initiative this year to extend the program, MTN News has learned.

The ballot measure, if crafted properly and approved by voters in November, would extend coverage, include some reforms of the program and direct lawmakers on how to fund the state’s multimillion-dollar share, said state Sen. Ed Buttrey, R-Great Falls.

In its current form, Montana’s expanded Medicaid program covers 91,000 low-income Montanans and is bringing $1.25 billion of federal money into the state during fiscal 2018 and 2019.

The federal government currently covers about 95 percent of the cost, but that share will drop to 90 percent by 2020. The state’s share for fiscal 2020 and 2021 could be $150 million to $200 million.

Buttrey, the sponsor of the 2015 bill that authorized Medicaid expansion, said no decision had been made whether to pursue an initiative or what it would contain. When asked if he would support a ballot measure to extend the program past 2019, Buttrey said “it depends what the initiative says.”

Buttrey said he’d like to see health-care providers, health insurers and some of those covered by the program help pay the state’s share. He also said there should be stronger requirements that would exclude those who have substantial assets from getting the coverage.

“We need to make sure the (people) that are covered are the most needy Montanans, the ones that need help,” he said.

The program currently covers all adults earning up to 138 percent of the federal poverty level – about $16,600 a year for a single person – but doesn’t bar anyone based on financial assets they own.    

Those discussing a possible ballot initiative include hospital officials, other medical providers, health-care groups, low-income advocates and Gov. Steve Bullock’s office, MTN has learned.

Bullock, when asked this week by MTN News whether he would support an initiative to extend Medicaid expansion, said only that he’s “had discussions with folks” about how to extend the program.

Officials with MHA, the lobby group representing Montana Hospitals, declined to comment Friday.

The 2019 Legislature can vote to extend Montana’s Medicaid expansion past 2019, but supporters fear that Republican majorities in the next Legislature could reject it.

A public vote in November in favor of an initiative to extend the measure would put it into law – but lawmakers still would have to authorize state funding for the program.  

A coalition of Democrats and moderate Republicans at the 2015 Legislature approved Medicaid expansion, but supporters of the program have said they’re not sure that same coalition would hold at the 2019 Legislature.

Republicans hold a 59-41 majority in the current Montana House and a 32-18 advantage in the Senate. The 2018 election likely will change that makeup, but most observers believe Republicans will still maintain solid majorities.

Placing an initiative on the ballot requires the signatures of at least 25,468 registered voters statewide and at least five percent of the registered voters in at least 34 state House districts. The signatures must be turned into county election officials by June 22.

Buttrey said one consideration of whether to run a ballot measure would be the cost of gathering signatures and the campaign to pass it.

“It could cost millions of dollars to run a campaign,” he said.