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Barreling toward a Medicaid cliff

by Sheila Hogan
| June 12, 2022 12:00 AM

Nearly 300,000 Montanans, including 128,000 children, rely on Medicaid for their health care coverage. Nearly 2 in 3 businesses have an employee who is covered by Medicaid, making it a critical support for Montana’s small businesses and entrepreneurs who can’t afford to compete with big corporations on worker benefits. Medicaid keeps our families healthy and our economy running, so why are we choking it with new red tape?

Because that’s what’s happening right now – unnecessary bureaucracy is growing in Medicaid, not shrinking. During the last session of the Legislature, Montana Republicans pushed forward legislation that requires Montanans to continuously prove their eligibility for Medicaid – every few months, you must report your income to the state government, despite the fact that you already told them when you signed up for Medicaid and you’re already required to reapply every year like everyone else with insurance does.

Montana Democrats fought against these new requirements, but the Republicans were dead set on adding additional superfluous red tape to one of the state’s largest and most critical insurers.

Within the next few months the state will kick off this “eligibility redetermination” for working Montanans covered by Medicaid. This could have serious and far-reaching consequences for the hundreds of thousands of Montanans who are covered by Medicaid. You might rely on Medicaid to cover your insulin or the cost of your kid’s inhaler, but if you don’t jump through a hoop when the government tells you to, you might be out of luck.

No matter that you’re working two jobs, or picking up extra shifts, or have moved from your old address when your landlord jacked up your rent. If you miss that notification in the mail or don’t respond right away, you’ll lose your family’s health care.

No matter that you work seasonal jobs where your income fluctuates from month to month. If you don’t fit in the government’s narrow “eligibility” box at the random time they decide to force you to prove it, you’ll lose your family’s health care.

And let’s say you get kicked off your health care even though you still qualify for it. The wait times on the state phone line to fix that problem can take days, so good luck trying to get signed back up again. The state government is currently undertaking a so-called “red tape review” to supposedly cut down on government bureaucracy, but they’re completely ignoring the source of quality, affordable health care for a third of Montanans. Instead of working to lower the costs of living for working families, they're stringing up more red tape in Medicaid and letting Montanans get clotheslined by it. It’s unconscionable and it needs to change. Red tape doesn’t belong in Montana – and especially not in our health care.

For many Montanans, Medicaid is the difference between life and death. Nothing made this more clear to me than my tenure as Director of the Department of Public Health and Human Services. I spent hours on the phone with folks across Montana who needed help navigating the eligibility process, who had fallen through the cracks because they missed the deadline; or the paperwork got sent to their old address; or they worked three jobs and didn’t have time during working hours to call with questions.

One case in particular has stayed with me for years. A working mother received health insurance under Medicaid, and because of her coverage, was able to catch her cancer early. Finding the time to navigate the eligibility paperwork for Medicaid, while balancing working, cancer treatment and taking care of her children, was nearly impossible. I was happy to help her through the process. But not everyone is lucky enough to get that kind of help.

The changes the Gianforte administration will implement this summer make an already complex system more burdensome. Adding red tape and redundant eligibility requirements will make it easier for Montanans like the mother juggling work, child care, and cancer treatment to fall through the cracks and lose their health care coverage.

If we are serious about removing red tape in state government, the solution is simple. Roll back these cumbersome, ineffective bureaucratic requirements and provide hardworking Montanans with the health care they’re eligible for.

Sheila Hogan is the executive director of the Montana Democratic Party and former Director of the Department of Public Health and Human Services.

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