HELENA — The biggest issue of the 2019 Legislature will be under the spotlight Saturday, as a House committee plans an all-day hearing on the two competing bills to continue Medicaid expansion, the $750 million-a-year program that provides government-funded health coverage to 95,000 low-income adult Montanans.
“I think it’s going to be a real opportunity for people to finally see and hear what the differences are between the two proposed actions,” House Minority Leader Casey Schreiner, D-Great Falls, said this week. “I think once people have an opportunity to hear about both bills, people will know for sure that there is a real solution, and then there’s politics.”
Schreiner’s preferred “real solution” is House Bill 425, sponsored by Rep. Mary Caferro, D-Helena, which extends the program with a few minor changes. Gov. Steve Bullock and fellow Democrats are behind it, saying Medicaid expansion has been a smashing success that doesn’t need an overhaul.
But Republicans, who control majorities at the Legislature, have different ideas of what Medicaid expansion should look like. Those who want to continue the program are behind House Bill 658, which was just introduced this week by Rep. Ed Buttrey, R-Great Falls.
Buttrey’s bill tightens up eligibility for the program, requiring participants to take part in 20 hours a week of “community engagement,” which could be a job, looking for a job, volunteer work or other activities.
The House Human Services Committee will start Saturday’s hearing at 9 a.m. with Caferro’s bill, at Room 303 in the state Capitol.
Rep. Dennis Lenz, R-Billings, who chairs the panel, said he’s allotted four hours for HB425. If the hearing takes that long, the committee will then take a half-hour lunch break and return to hear Buttrey’s bill in the afternoon.
“Part of the reason why I did the Saturday hearing, I want to hear the whole gamut of how (the bills) interconnect,” he said on Friday. “That’s kind of what I’m aiming for.”
Medicaid expansion, approved by the Legislature in 2015, provides mostly free coverage to able-bodied adults earning up to 138 percent of the federal poverty level, which will be about $17,200 a year for a single person as of April 1.
But the 2015 law set a June 30, 2019, expiration date for the program, so the Legislature could re-examine it and decide whether and how to continue it.
The federal government pays 90 percent of the cost, but the state must cover the remainder. Buttrey’s bill has budgeted the program for $1.5 billion over the next two years.
Some Republicans oppose the program outright. Others say its eligibility needs to be tightened, so those who aren’t truly needy don’t take advantage of it. They also say the program should not become a permanent benefit for people.
“Medicaid expansion should be for the group that’s kind of maybe in transition,” said Lenz. “They’ve had some tough times, they need to maintain some health care … We want to be able to provide them with something that can be a stepping stone to get them over this hump, over this difficulty.”
Buttrey’s bill includes not only the community-engagement requirements but also a fee that would be charged to people who own certain amounts of property, including agricultural property.
Democrats say the additional requirements are merely “bureaucratic barriers” that will kick people off the program for no good reason, and with no real evidence that anyone is taking advantage of it.
“Those in the Republican Party have created this narrative where they actually are saying bad things about people in the state of Montana, (but) they’ve had zero proof or evidence to back up that’s existing,” Schreiner said. “We’ve heard talking points and we’ve heard innuendo, but I have yet to have somebody actually show me data that supports any of those claims.”
The committee plans to vote on the bills next Friday.