Uncertain times for Medicaid benefits
About 75,000 low-income Montanans will continue to have access to critical health benefits thanks to a coalition of moderate lawmakers who rallied last week to permanently renew the state’s Medicaid expansion program.
The bipartisan vote of support sends House Bill 245 to Gov. Greg Gianforte’s desk, where he is expected to give the measure its final stamp of approval.
The Medicaid expansion program is a vital safety net for Montanans aged 19 to 64 with annual incomes at or below 138% of the federal poverty level — about $21,500 for individuals. The program offers benefits like nursing home care, personal care services and assistance paying for Medicare premiums and other costs.
Without the expanded program, tens of thousands of vulnerable Montanans would likely go uninsured and end up taxing the state’s already fragile rural health care system. Some experts worry that without Medicaid, hospitals and health centers could be forced to shut down.
The reupped program does wield some pertinent sideboards, like work requirements that had been blocked under the Biden administration but are expected to be lifted under President Trump.
A vast majority of Montanans support the expanded program — 75% according to a recent AARP poll — and it’s refreshing to see Republicans and Democrats join in the push to get this legislation across the finish line.
But trouble may be lurking on Capitol Hill.
The federal government covers 90% of Montana’s $1 billion Medicaid expansion budget, with the state’s cost totaling about $100 million. That percentage is far from secure as Congress grapples with an impending tax-cut bill.
A budget plan narrowly approved in the House last week calls for an $880 billion spending cut from the House Energy and Commerce Committee, which has jurisdiction over Medicaid. Budget experts say it will be difficult, if not impossible, to find those savings without offloading a higher percentage of the cost sharing program to the 41 states that take part in expanded Medicaid. If that happens, Montana has a trigger mechanism in place that ends its program.
It’s up to Congress to make sure the program that largely benefits rural Americans stays intact, and so far, Rep. Ryan Zinke is standing firm in his position that it will.
The Republican from Whitefish is hopeful sufficient savings will be found by the Department of Government Efficiency to meet the $880 billion goal.
“Elon Musk has said there is going to be a trillion dollars, with a ‘T,’ a trillion dollars in waste, fraud and abuse,” Zinke said in an interview with CNN last week when asked about Medicaid cuts. “But again, that’s what he says. We have to confirm, that’s what it is. And if it is confirmed, then you can have the savings of it.”
Here’s to hoping he and Musk are right. The safety net that protects so many of his constituents, local businesses and rural hospitals is hanging in the balance.