Victoria Eavis, The Missoulian
Maintaining Medicaid expansion is set to be one of the most consuming issues of the 2025 legislative session and Democrats are projecting confidence that it will get across the finish line.
In a press briefing Monday, Rep. SJ Howell, D-Missoula, said there "is a clear path to getting this done" when talking about renewing Medicaid expansion. Rep. Mary Caferro, D-Helena, echoed Howell's faith.
"Continuing our current Medicaid program is the most important job we have," Howell said, adding that Democrats would like to see "continuous eligibility" added back to the health care program so that brief changes in income or who is living in one's household would not trigger coverage to immediately end.
That said, there is already a considerable push to roll back Medicaid expansion as a whole, with those against it often arguing that the state resources put toward the health care program do not improve overall health outcomes.
The program is slated to sunset in June of 2025 if the Legislature does not intervene. As of August, just over 78,000 Montanans were covered by Medicaid expansion.
In 2014 the federal government allowed states to extend Medicaid coverage to people who earn up to 138% of the federal poverty level, which is about $21,000 a year. Across the U.S., 41 states have implemented Medicaid expansion.
Montana has already renewed Medicaid expansion once since it first implemented the program in 2015.
Some Democrats, like Representative-elect Jane Weber, D-Great Falls, wants to see the sunset date done away with entirely. The Republican appetite for that is likely minimal, and Democrats will need their colleagues across the aisle to get any legislation passed this session.
There were some key legislative wins for Medicaid expansion backers, including two Republican state senators who won their elections in tight races who have previously said they plan to vote in favor of the program.
What's more, Republican Gov. Greg Gianforte's initial budget proposal includes funding for Medicaid expansion to continue as is, which Democrats took as a positive sign. That said, the governor is also in favor of work requirements being tied to the federal-state health care program.
Likewise, Sen. Greg Hertz, R-Polson, previously told the Montana State News Bureau that the real debate on Medicaid expansion will likely come down to work requirements as opposed to the program as a whole.
"I think it makes sense for any social benefit program," Hertz said of the work requirements Monday. "We want them to get back into the workforce so they don't have to depend on the government."
In 2019, when lawmakers in Helena last re-upped Medicaid expansion, there were work requirements tied to the bill that were never implemented.
Democrats vehemently oppose work requirements being a part of Medicaid expansion eligibility, as they say most Medicaid enrollees are already working and they point to the federal government's previous rejection of work requirements being a part of the health care program in Montana.
"[Work requirements] are not necessary," Caferro said Monday. "They're code clutter."
That said, with the new presidential administration there is renewed confidence — including from Gianforte and Hertz — that work requirements may be easier to implement.
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