Montana Senate Passes Medicaid Expansion Reauthorization

The bill to continue Medicaid expansion in Montana passed out of the state Senate Tuesday after teetering on the edge of a deadline for end of session negotiations.

The reauthorization of the health coverage program for low-income adults, packaged with new work and public service requirements for certain enrollees, passed 28-22 in its final Senate vote.

Around 96,000 people are currently covered by expanded Medicaid in Montana.

The plan to continue it was immediately criticized by Senate Majority Leader Fred Thomas, a Republican from Stevensville, after it passed out of the Senate.

"It’s the most pathetic example of a work requirement that one could ever dream up," Thomas said.

Eight Republicans joined all 20 Democrats in the Senate to pass House Bill 658 on the final day before a legislative deadline for bills to pass.

Democrats are calling the bill a win, but also a compromise. They wanted to continue health coverage, but without any new requirements on enrollees.

A statement issued after the vote by Senate Minority Leader Jon Sesso, a Democrat from Butte, said that since Medicaid expansion became law in the state in 2015 it’s helped more people get preventive healthcare. The statement said, "More Montanans are working and contributing to our economy."

The expansion bill, HB 658, now moves back to the House. Lawmakers there are expected Wednesday to debate changes made to the bill made by the Senate. Those include a 6-year sunset on the policy, meaning it will expire in 2025 unless another agreement to continue it is reached by the Montana Legislature.

Over the last week, a group of Republicans withdrew their support for the expansion bill, stalling it in the Senate in an attempt to gain leverage for other policy goals.

Republican Sen. Duane Ankney of Colstrip, voted for the Medicaid expansion policy Tuesday after he says those negotiations didn't lead anywhere.

"It was never my intent from the start to kill the Medicaid expansion bill. My intent from the start was to try to bring some pressure to get the governor to negotiate with us on pro-jobs, pro-economy, pro-revenue bills."

Ankney and other Republicans, including Senate President Scott Sales, say they wanted to see more support from Democrats and Governor Steve Bullock for bills benefiting natural resource development in the state.

One of the bills involved in those negotiations was Senate Bill 331, which attempted to give NorthWestern Energy incentives to buy a larger share of the coal-fired power plant in Colstrip.

That bill failed to pass out of the House Tuesday.

Sen. Tom Richmond, a Republican from Billings, says he was surprised to see the House reject it, given its initial approval of the bill earlier this week. However the bill that some labeled an attempt to save Colstrip, was heavily amended by the House, and Richmond says it was no longer the same bill that he supported.

"Frankly, I’m not sure I would have voted for that bill either, by the time they got done with it."

Richmond says it’s possible that concepts of the SB 331 Colstrip bill could get amended into another piece of legislation in the coming days.

It’s unclear if the recent interwoven politics of coal-fired power and health care for low-income adults will continue now that the Medicaid expansion bill is again in the hands of the House.

With 10 days left in the legislative session, Medicaid expansion must pass additional votes in the House before heading to Governor Steve Bullock’s desk.

Governor Bullock has been urging lawmakers to give him a Medicaid expansion bill to sign for several months. The state’s current policy expires July 1, if not reauthorized.