by Steve Muth, of Red Lodge. Muth recently retired as Red Lodge City Judge.
Several prominent Republican legislators, most all of whom are steeped in the tea party, oppose Governor Bullock’s plan to expand Medicaid coverage for poor and disabled Montanans. Recently, all 10 Republican members of the Montana House Human Services Committee voted a “do not pass” recommendation on Medicaid expansion, meaning that the tea party Republicans will force a supermajority, or 60 Representatives, to bring the measure to the full house for a vote. A supermajority would require that Democrats along with several moderate, independent-thinking Republicans vote to bring the measure before the House for a vote. Tea partiers hope that they can keep the rest of the Republican legislators in line with the kind of threats and intimidation they and their out-of-state political pressure groups have made in the past against moderate Republicans in the Montana legislature.
It is believed by many that a majority of legislators favor the Governor’s proposal, but conservative, tea party Republicans will do all they can to prevent an honest up or down vote in the legislature.
The arguments of the tea party Republicans against Medicaid expansion are in three broad categories: that the private marketplace, without any interference from hated Big Government, can be relied upon to solve our health care problems; that the refusal to expand Medicare is proof of their own hatred of Obamacare and thus their standing within their own party; and that Medicaid expansion is a free government handout to underserving able-bodied Montanans who refuse to work.
None of these ideological arguments hold water. In order for Medicaid expansion to receive the consideration it deserves in our legislature, it will be necessary for some Republicans to stand up to this narrow-minded thinking of tea partiers and insist that there be a full house vote on this important issue.
The argument that the marketplace can and will solve all our problems has been made again and again by members of the tea party, but offers no solution to a great variety of social problems, chief among them access to health care. In 1997 the Montana legislature refused to expand coverage to poor, uninsured Montana children. Some coverage was expanded by the 1999 legislature, and then Montana voters in the 2008 general election, after further legislative refusal to act, overwhelmingly passed I-155 which effectively established the Health Montana Kids Plan, which has achieved considerable success in bringing accessible health care to poor children in Montana.
During discussions in 2007 at the time of earlier legislative attempts to extend coverage to poor children, I recall then-Representative Scott Sales, Republican legislative leader, saying that he opposed spending one more penny on children’s’ healthcare, refusing to acknowledge that there even was a problem with health care for poor, sick and uninsured children. He said that “if” there was a problem, he trusteed that the corporate ”marketplace” would take care of it. What he left unsaid was that there is no profit incentive for the “marketplace” alone to offer health coverage to poor children, so that the reliance on the “marketplace” to address the needs of those more vulnerable in our society is an illusion. Today, Representative Sales remains a leader in the Montana legislature, still promoting hatred of Big Government and Obamacare, the political excuse for avoiding honest consideration of the proper role of government in our society .
Even today, children’ health care is still under attack in the Montana legislature. In this current 2015 legislature, Representative Art Wittich, chairman of the House Human Services Committee and who, with impeccable tea party credentials forced throughhis committee the “do not pass” recommendation for the Governor’s Medicaid expansion proposal, introduced a bill to prohibit government supported health care for poor children whose entire family assets are more than $20,000, an amount apparently considered to be the threshold of wealth. It would make as much sense to require each legislator to pay out of his own pocket all of his own childrens’ health care bills until his family assets drop below $20,000. Fortunately, this bill was tabled in committee. But members of the legislature, of course, keep their own government subsidized health insurance.
Ideological arguments are dogma to the tea party Republicans, and are made to avoid a fact-based debate about government’s responsibility to assist and grow a healthy Montana workforce. The Republican legislators who invoke a visceral hatred of Obamacare do not have to engage in a truthful debate about the benefits to the state of Montana from expanded Medicaid.
Conservative Republican legislators tell us that Medicaid expansion fosters Big Government so that not one penny of federal money will be accepted back into Montana to pay for the expansion. So instead of accepting back into Montana money that we pay out in federal taxes, Republican Representative Nancy Ballance has sponsored legislation that is a half-hearted expansion of Medicaid, extending coverage to a limited number of deserving Montanans. This legislation proposes to pay for limited Medicaid expansion by spending Montana’s own state tax dollars. Should this alternative to Governor Bullock’s plan become law, it would cost as much or more to the state treasury to insure 10,000-15,000 needy Montanans than the Governor’s plan which would cover over 60,000-70,000 Montanans by accepting our fair share of our federal tax dollars.
Although under the Governor’s plan Medicaid expansion would be paid for initially by 100% federal dollars and no more than 90% thereafter, with the match on a sliding scale and the 90/10 level reached not reached until 2020, we are told that we must refuse this support because the federal government cannot be trusted to make its promised payments. This ideological argument ignores the provision in the Governor’s plan which would terminate expanded coverage when and if the federal government failed to make transfers to Montana as promised. When ideology trumps fact, citizens become the victims. All we hear from the tea party Republicans and their “American prosperity” backers is that expanding Medicaid with cost money to the state of Montana. Aside from their attacks on accessible health care for the poor, never have any of these politicos advanced any positive idea to serve the needy in our state and never have they admitted what the real cost to the state will be by failing to expand Medicaid.
Instead of invoking Big Government to avoid its legitimate responsibilities, the question we should ask is “What are the responsibilities of government and how can we satisfy these responsibilities?”. Do we or do we not have a responsibility to provide access to health care to poor, uninsured children? Do we or do we not have a responsibility to provide better access to healthcare to veterans, the disabled, the working poor. Providing reasonable access to health care should be a moral imperative shouldered by responsible government, and which promises to strengthen the overall Montana economy.
The tea partiers unrelentingly pursue a war against the poor in Montana. In 2013, another Republican legislative leader, Billings Representative David Hagstrom, who makes a living from Section 8 and other government housing subsidies for his low income renters, told his tenants, as reported by the Billings Gazette, that they don’t need “to live as long as they currently do, or as ‘comfortably’ as they currently do.” He reportedly told his low-income renters “to accept the fact that you and your neighbor are going to have to work harder than ever, maybe take take a second or third job and live on less….” Representative Hagstrom is still in the legislature and is appointed to the Joint Appropriations Subcommittee on Health and Human Services, responsible for setting the state budget for Montanans in need.
In 2013, I travelled to Helena to testify before a Senate committee in favor of expanded Medicaid coverage and I heard comments made about “deadbeats” who want something for nothing through expanded Medicaid coverage. This attitudes still guides some Republicans in the 2015 legislature where we hear continuing references to alleged fraud in the “system” and allegations about able-bodied people who refuse to work but who nevertheless want government supported health care. Some Montana Republican legislators are content to group poor Montanans into an underclass unworthy of Medicaid expansion.
Who are these low income Montanans who would be covered under the Governor’s plan for expanded Medicaid? Are they deadbeats looking for a government handout, or are they working and disabled citizens caught in the net of expensive and unaffordable health care and health insurance costs?
According to information provided by the Montana Budget and Policy Center, those who would be covered under the Governor’s plan include over 9,000 veterans, thousands of American Indians, nearly 40,000 other working Montana adults. These include the many thousands of able-bodied Montanans who do work and whose income is too low to afford insurance coverage. These workers are waitresses, day care providers, hospitality workers, farm and ranch laborers, and thousands of others who hold down a jobs that we all rely on to our benefit. These workers are not deadbeats and do not deserve to be treated that way. It is no answer to hector them that they should get a second or third job, or that they should expect to live a harder, shorter and less comfortable life.
The alternative plan introduced by a select group of Republican legislators, would cover perhaps 15,000 Montanans who surely deserve assistance with health coverage, but would exclude many thousands more who also merit this assistance. Data recently released by the Corporation for Enterprise Development shows that Montana ranked 49th in the country for average annual pay, 42nd in the number of low-wage jobs and last for employers offering health insurance. Montana has also been said to be at or near the bottom for uninsured or underinsured veterans and Native Americans.
It could not be more clear that good government should act to expand Medicaid to the working poor and disabled in our state. The Governor’s plan is the right place to start.
Steve Muth, Red Lodge