The Montana Senate today voted to move forward with a bill by Sen. Dave Wanzenried (SB 395) to reform and expand the Medicaid program in Montana to working poor people–people whose employers don’t provide health benefits or don’t pay enough for people to afford to buy it on their own. The expansion program is called Access Health Montana.
Now the more conservative House must approve it as well.
Republicans have been hesitant to support the idea until now, even though it would mean billions of federal dollars for Montana. This is not surprising. Using government spending to create jobs (one of the Democrats’ strongest arguments for this proposal) is something that Republicans are claiming they fundamentally oppose, (though not when it comes to highway funding or farm subsidies apparently). So a few moderates joined in with the Dems, and the bill passed.
That hasn’t stopped many GOP legislators on the right wing from doing what they do best–spread misinformation.
During debate, for example, Sen. Art Wittich revealed that he has a most embarrassing lack of understanding of the bill–or perhaps he just decided to openly lie about it.
Wittich claimed there was “no cap” to the Medicaid expansion –that it would be infinitely costly for the state. That’s false. Eligibility is capped at 138% of the Federal Poverty Level – that means it’s limited to people who make less that that amount, about $15,000 for a single person.
He also made the ludicrous statement that instead being benefited by a Medicaid expansion, the uninsured should simply “use welfare” to buy health insurance. That’s not possible. Temporary Aid for Needy Families (TANF)–what Wittich calls “welfare”– is only for people with kids. It’s also temporary (hence the name). Families can only get the benefits for a limited time. There is no possibility of it being used for a purchase of health insurance.
Unlike TANF, Access Health Montana (the Medicaid Expansion plan that the Senate voted up) is not limited to people with kids.
Thankfully, a few GOP Senators looked into the facts of the matter, rather than relying on Wittich’s fibs. Llew Jones, Taylor Brown, Bruce Tutvedt, Ed Buttrey, and Jim Peterson are all Republicans who voted for the bill. All Democrats voted yes.
These Republicans made a smart choice. Access Health Montana is the only way to keep federal healthcare dollars in Montana now that Obamacare is the law of the land. If Montana doesn’t expand Medicaid, our federal tax dollars will go to the other states that do–instead of being spent here in Montana to boost our own economy.
That would translate to a $700 million annual loss to Montana’s future Gross Domestic Product. This probably doesn’t mean much to TEA Party dunces, but the GOPers with basic economic sense get that the expansion of Medicaid would add an additional 1.7% to Montana’s GDP for the next eight years. For context, understand that a 1.7% addition would roughly double the expected GDP growth rates for the next several years in this state.
The Medicaid expansion also helps states deal with some of the things Republicans say they don’t like about Obamacare.
For example, it protects small local hospitals and rural health care centers from federal cuts. Keeping the doors open to Montana’s rural hospitals means keeping jobs in their districts from being eliminated, and allowing rural Montanans access to medical care for which they would otherwise have to drive many hours.
It would also protect Montana employers from what the GOP calls “Obamacare penalties” – tax increases. The Affordable Care Act levies a tax on any company that employs 50 or more workers that does not provide workers with health insurance. This tax is alleviated or eliminated for many employers if these same workers can now get Medicaid. A recent private-sector report by Jackson Hewitt estimated that Montana companies will face an additional $10-15 million in tax penalties without the Medicaid expansion for this very reason.
Finally, Repubs who bothered to inform themselves about Bullock’s proposal know that Montana can do a trial run of the idea. For three years while the federal government is paying for 100% of the cost of benefits, Montana can opt-in to the expansion and see how things work. When the state is asked to start picking up a meager portion of the cost (the most states can be asked to pay is 10% and even then not until 2020), Montana has the legal authority to roll back the extension to the way things are now.
For these reasons, I expect that once Republicans have a chance to think about it this will pass the state House, with perhaps a few minor edits to increase the emphasis on reform. Certainly it doesn’t hurt that the GOP’s major electoral engine, the Montana Chamber of Commerce, has endorsed the idea too.
And don’t forget that an earlier version of Bullock’s proposal, HB 590, by Rep. Chuck Hunter has already received a majority of more than 50 votes on a (procedural) vote in the house. This latest version with its increased emphasis on reforming Medicaid and room for GOP input will be able to pick up more votes.