Montana Legislature

GOP lawmaker: Medicaid expansion can pass MT with reforms

Posted: Mar 13, 2013 7:27 PM by Marnee Banks - MTN News

Montana Governor Steve Bullock (D) has officially introduced his plan to expand Medicaid to 70,000 more Montanans. However, a leading Republican says the bill won't pass the Legislature without some reforms.

Bullock wants to increase Medicaid eligibility so a family of four making $32,000 a year would have access to government-run health insurance. Right now the cap sits at $8,000 for a family of four.

"We need to do this to take care of our citizens and create jobs in Montana," Bullock said in a February press conference announcing his Access Health Montana plan.

But not everybody thinks this is great idea. Chairman of the Senate Public Health Committee Jason Priest (R - Red Lodge) says he can't justify expanding Medicaid when it has worse health outcomes than the private insurance system.

"It's going to be very difficult for Republicans to vote to expand Obamacare, create a new entitlement, one that is incredibly expensive for the state of Montana, without any type of reform," Priest said in an interview. "I think that's a political loser, and I think it's just bad policy."

So Priest is introducing a bill which creates a committee to come up with reforms.

The committee would look at having Medicaid recipients share in the cost of their healthcare, and explore moving Medicaid to a private insurance system.

"We have significant cost shifting from both Medicare and Medicaid to private health insurers. That is a tax on small businesses and families," Priest explained. "If the Medicaid population were to obtain their health insurance in the same way, then competition among health insurance companies should lower the premiums and lower the cost shifting."

His bill also asks the committee to look at the non-profit status of hospitals. Priest says hospitals provide a majority of the healthcare in Montana and they should have some skin in the game.

"We need the provider community to join in a general prosperity effort. If they don't pay taxes, they don't care what other people's taxes are," Priest explained.

Under his proposal, the committee would study these options after this session is over and bring a plan before the 2015 Legislature.

"Let's not do what the federal government did and pass a bill to find out what's in it," Priest said. "Let's instead take a structured approach to looking at innovation, expansion, and reform all in one package."

Priest says Republicans can help Democrats pass Medicaid expansion if Democrats will agree to help Republicans reform it.

Now that Bullock's Medicaid expansion bill is officially introduced it can be scheduled for a hearing.

According to the bill, the cost to expand Medicaid for the next two-year budget cycle, is estimated at $25 million. Of that, $5 million comes from the state and $20 million comes from the federal government.