HELENA — The crowd started gathering early for Saturday’s dual hearing before the House Human Services Committee on the two competing bills that would continue Medicaid expansion: the $750 million-a-year program that provides government-funded health coverage to nearly 100,000 low-income adults in Montana.
First up was House Bill 425, which extends the coverage with few changes.
The sponsor, Rep. Mary Caferro, D-Helena, began her testimony by acknowledging the huge crowd in favor and talking about the three-year-old program’s success in bringing health coverage to thousands of poor Montanans.
“We in 2015 passed a monumental piece of legislation that has created better health outcomes all over the state, rural and urban,” Caferro said.
More than four hours later, the panel began its hearing on House Bill 658, the Republican alternative from Rep. Ed Buttrey of Great Falls, who sponsored the original bill in 2015.
Buttrey said the program has done much good, but that his bill will improve it, for enrollees, and the taxpayers paying the tab.
Buttrey said, “That we can get more people self-sufficient, that we can create more jobs and we can do so in a way that applies and assures to the taxpayers of Montana that their money is being spent in the most responsible way possible.”
The Buttrey bill would require many program participants to log 20 hours of “community engagement,” which is a job, or other activities.
Most came to Helena to support Caferro’s bill, and Medicaid expansion.
Native Americans said it’s been a huge boon for health care on Indian reservations, enabling tribes to expand services and offer prevention, instead of just treating symptoms.
“I fully support Medicaid expansion; it has done wonders, and it’s more than just Indian Country. These are your most sensitive population, these are your most vulnerable people in your guys’ districts, that this affects,” said Jennifer Show, a nurse practitioner from Fort Belknap.
Dentist Joanna Waley of Livingston said the dental coverage has helped scores of people who previously couldn’t afford care get things like dentures.
“Without teeth, people are relegated to back-room stocking, dishwashing or simple unemployment. It’s hard to get a job if you do not have front teeth,” Waley said.
But many of those for Caferro’s bill opposed the Buttrey bill, saying its additional requirements would end up disqualifying thousands of people.
Mary Dalton, a former DPHHS administrator, said, “Community engagement or work requirement will be an artificial barrier to health coverage that will cause people to lose coverage — not because they don’t want to work, but because it is so administratively complex to get through there, some people who throw up their hands and give up.”
There were those who opposed the entire program, calling it “socialism” and saying the country can’t afford it.
Senator David Howard, R-Park City, said, “We’re really adopting a socialist-type program. There is one thing that is very interesting about socialism, is that it’s never succeeded. All we have to do is look at Greece, and then, recently Venezuela.”
But if one thing was made clear, it’s that Medicaid expansion has had a huge impact on the health-care landscape of Montana. Now, it’s up to the committee and the rest of the Legislature to what the program may look like in the future.
-Mike Dennison reporting for MTN News