Time for action on Medicaid expansion

In 2015 Democrats and Republicans in the Montana Legislature put aside their partisan and ideological differences, and taking advantage of the federal Affordable Care Act, expanded Medicaid coverage to more than 90,000 low income Montanans, almost 10% of the state’s entire population. That was a decision from which Montana would profoundly, and proudly, benefit.

It meant that 90,000 of our neighbors would now get the regular and preventative health care that most Montanans enjoy, rather than having to wait to get sick and wait in a hospital emergency room when they needed care. It also meant that parents didn’t need to worry about going broke when they took their kids to the doctor. It meant that health care providers, rural hospitals and Indian Health Service clinics, struggling to keep their doors open as costs went up and revenue lagged, were given much needed relief. 

And since the federal government picked up over 90% of the cost of Medicaid expansion, it was a great deal for Montana taxpayers: some of our dollars we sent to Washington were coming back home and doing good work. 

But now Medicaid expansion is being threatened by neglect, incompetence and political hostility. 

During the pandemic, Congress allowed people enrolled in Medicaid to stay enrolled, without having to demonstrate they still qualified for coverage. When the crisis was over, that ended. Across the country, more than 20 million people lost coverage until they could demonstrate they could still qualify. 

Loss of coverage wasn’t supposed to be that bad: states were expected to re-enroll those who still qualified within 45 days, and indeed most states did a lot better than that. Nationally, more than two thirds of re-enrollment applications were processed within a week. 

But not by the Gov. Greg Gianforte administration in Montana. Over 130,000 Montanans were kicked off Medicaid last year. Getting them re-enrolled has taken a nightmarish amount of time, and many applications have been rejected or still not been processed. 

Almost 40% of re-enrollment applications have taken more than 45 days to process, making Montana one of the worst states in the nation to leave people hanging, unable to pay the doctor bills for themselves and their kids, or not going to the doctor when they really need to. Meanwhile hospitals are laying off employees and freezing needed hires. 

It wouldn’t surprise anybody to find out that the Gianforte administration is deliberately trying to undo Medicaid expansion: after all, it’s up for reapproval in the 2025 legislature, and extremist Republicans have already said they will attempt to scuttle it. In that effort, they can always hope to get a hand from Ryan Zinke.

Where is Zinke in all this? He hasn’t spoken up on behalf of thousands of Montanans losing health coverage, but has aligned with Gianforte in other extremist positions. Zinke has been part of the most unproductive Congress in history, spending time on chaos and petty in-fighting rather than voting to get the nation’s business done. 

As a party loyalist and member of the Republican Study Committee, Zinke has allied himself with extremists in his party who would raise the retirement age for Social Security and Medicare, stop allowing Medicare to negotiate drug prices, and repeal both the $35 Medicare cap on the price of insulin and $2,000 cap on Part D out-of-pocket costs. 

In other words, when it comes to federal programs essential to the welfare of Montana seniors, Zinke aligns with those who would defund and remove them. 

I guarantee you I will not do that. On the contrary, in Congress I will work to defend and enhance the programs that provide all Montanans and all Americans with access to affordable and high quality health care, and seniors with the retirement income they paid for and were promised.

Monica Tranel is the Democrat candidate for Montana’s western district U.S. House seat. She lives in Missoula.