The Bullock administration this week implemented nearly $15 million in cuts to payments for those providing medical services to the poor and disabled in Montana, after a legislative panel voted to remove a legal barrier to the cuts.
The administration cut Medicaid payment rates by 2.99 percent – payments made to thousands of health-care providers, from hospitals to assisted-living centers to services for the mentally ill and disabled.
The cuts, effective this week, had been blocked since last summer by a formal objection filed by the legislative Children, Families, Health and Human Services Interim Committee.
But on Dec. 29, five members of the eight-person panel voted in writing to remove the objection, allowing the cuts to go forward.
The panel members voting to lift the objection were Republican Sens. Eric Moore of Miles City and Al Olszewski of Kalispell, Republican Rep. Dennis Lenz of Billings, and Democratic Reps. Kathy Kelker of Billings and Gordon Pierson of Deer Lodge.
Kelker, who had voted consistently against the objection, told MTN News that the cuts were the result of a bill passed by the 2017 Legislature and couldn’t be stopped. Delaying them any longer would just make them more severe when implemented, she said.
“I didn’t think (the delay) was fiscally responsible,” she said in an interview. “It was never going to result in eliminating the cuts. That wasn’t going to happen.”
However, Kelker did say she felt that state health officials never fully explained the rationale for the level of cuts or their effect on services provided to the poor and disabled.
The chair of the committee, Democratic state Sen. Mary Caferro of Helena, opposed lifting the objection, and told MTN News this week that she wanted the Bullock administration to explain why it chose the 2.99 percent and whether other steps could be taken to mitigate the cuts. They never did either, she said.
“The objection was never about the level of cuts,” she said. “It was about `How did they get to that level?’”
But Caferro did say cutting rates for Medicaid providers is having a devastating impact on community-based programs that help the mentally ill and the disabled.
“Why would we start with people in our state who have disabilities?” she said. “Why would you start with cutting the supports that they need to live in the community and be independent? …
“When you rely on (someone) to show up to help get you out of bed, help you shower, eat and get off to your work day, and there is nobody showing up, can you imagine what that must be like? And that’s what we’re cutting.”
The cuts to Medicaid providers total $14.5 million over the next six months, in state and federal funds. They affect as many as 14,000 health-care providers – but some are exempt from the cuts, such as federally funded community health clinics.
These cuts are on top of human-service funding reductions imposed by the Legislature and the Bullock administration during a November special legislative session, in response to state revenue coming in much lower than predicted.
The Bullock administration this week told MTN News that the 2.99 percent rate reduction carries out the mandates in a law passed by the 2017 Legislature, that directed certain cuts if state tax revenue did not meet predetermined targets by last June 30.
That law is Senate Bill 261, which was heavily amended in the final days of the Legislature last April.
The bill said when the revenue targets weren’t met, the administration had to cut state health-care funding by $3.5 million this year, and take it out of Medicaid provider rates. It also said another $1.9 million should be cut from services to the mentally ill and developmentally disabled.
Federal matching funds tied to those expenditures also will be cut, bringing the total to $14.5 million.
Caferro, who voted against SB261, said the cuts were inserted into the bill with no public input or public hearing, at the last minute.
“I would say that many legislators had no idea that they were voting for such severe cuts,” she said.