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Montana Legislature passes Medicaid expansion bill

Associated Press, Modern Healthcare

The Montana House passed a bill Thursday to continue for another six years a program that provides healthcare for about 96,000 low-income residents.

The Medicaid expansion bill passed 61-35, just hours after accepting Senate amendments. It now goes to Democratic Gov. Steve Bullock, who is expected to sign it.

“This is a good day for Montana,” Bullock said in a statement. “We have once again demonstrated that when we put partisan politics aside and come together to do right by Montanans, government can make a meaningful impact in people’s lives.”

The action came on a busy day as lawmakers moved toward wrapping up the session next week.

The Senate gave final passage to a bill allowing the state to sell up to $80 million in bonds to fund building, water, sewer and bridge projects across the state. Lawmakers also passed a bill with a framework to set bonding limits based on the state’s revenue and debt and to prioritize maintenance work over new buildings.

Bullock signed a long-sought bill to remove barriers for firefighters to receive workers compensation coverage for illnesses, such as cancer and heart conditions, that could have been caused by exposure to chemicals while fighting fires.

Lawmakers also sent to a conference committee a bill that could be used to include an effort to authorize NorthWestern Energy to purchase an additional share of a coal-fired power plant in Colstrip along with additional access on a high-voltage power line. The committee is expected to meet next week.

Democrats and moderate Republicans supported the Medicaid program and reached a compromise between two proposed bills — one that would have continued the program much as it has been since 2016 and another that would have killed the program if the federal government rejected work requirements.

“Medicaid expansion has created thousands of jobs, thrown a lifeline to our rural hospitals, and provides critical health care for one in 10 of our neighbors,” said House Minority Leader Casey Schreiner. “There’s no longer any debate: Medicaid expansion works for Montana. We’re proud to see it head to the governor’s desk.”

The bill by Republican Rep. Ed Buttrey adds 80 hours of community engagement requirements per month, but does not tie federal acceptance of that provision to the continuation of the program. It also strengthens an asset test, increases premiums for people who remain on the program for more than two years, and requires Hutterite colonies to pay the state’s share of coverage for their members.

It also adds a tax on hospitals to leverage more federal funding. The Senate amended the bill to allow the health department to verify an applicant’s income with the Department of Revenue and included a June 2025 expiration date.

If the bill hadn’t passed, the program would have ended on June 30.

It’s estimated that the program could bring about $720 million in federal funding into the state in each of the next two fiscal years.

Opponents argued the program is not sustainable, contributes to federal deficit spending and there are too many exemptions to the work or community engagement requirements.

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