GOP unveils alternatives to Medicaid expansion
Mike Dennison | Hagadone News Network | UPDATED 10 years, 1 month AGO
HELENA — Legislative Republicans Tuesday rolled out their proposals to expand health coverage for the poor in Montana and reform health care, saying the plan is focused on “getting the right services to the right people.”
The plan, outlined at a Capitol news conference, is an alternative to Democratic Gov. Steve Bullock’s proposal to accept federal Medicaid funds to cover 70,000 low-income Montanans, they said — and targeted at those who really need it.
“This plan keeps Medicaid focused on the most needy in the state, and that includes children, blind individuals, disabled people, low-income seniors and parents,” said Sen. Fred Thomas, R-Stevensville. “Our plan [also] continues to incentivize work, and that is a significant difference to the governor’s plan.”
The plan includes nearly 20 bills, some of them not yet introduced, to expand government coverage for some poor Montanans, fund more local mental-health programs, limit liability for medical providers and encourage market-based solutions for health coverage.
“We as Republicans know that the most important thing is to get the right services to the right people and make sure we can pay for those over time,” said Rep. Nancy Ballance, R-Hamilton, who will sponsor one of the major proposals.
Ballance’s bill would extend Medicaid coverage to some low-income parents, spend $16 million to create more spots for disabled people on waiting lists for certain programs and enact new health-care management programs for Medicaid.
Republicans estimate their plan would extend Medicaid coverage and funded services to another 10,000 to 15,000 people.
Medicaid is the state/federal program that pays medical bills for the poor and disabled.
Under Bullock’s plan, every Montanan earning less than 138 percent of the federal poverty level (about $16,100 for a single person) would be covered by Medicaid. New people added to the plan would be funded almost entirely by the federal government — an estimated $700 million the next two years.
Rep. Art Wittich, R-Bozeman, acknowledged Tuesday the GOP’s coverage plans will need some additional state money, but if the state wants to innovate and maintain control of the programs, “we have to accept the fact that we have to use state dollars.”
House Minority Leader Chuck Hunter, D-Helena, said after the news conference that the GOP’s plan “wants to pick winners and losers, rather than address the entire needs of the population that’s not being served.”
“They don’t want to serve anyone who’s not working,” he said. “They’re simply excluding a large number of people just because they’re not in the workforce.”
Republicans have said they don’t want to extend Medicaid coverage to “childless, able-bodied adults,” who, if they have a job, should be able to buy federally subsidized health insurance through Montana’s online marketplace.
Medicaid expansion as proposed by Bullock is part of the 2010 Affordable Care Act, which directs states to expand Medicaid — with federal funding — to cover everyone earning less than 138 percent of the federal poverty level.
However, a 2012 U.S. Supreme Court decision made Medicaid expansion optional for each state. The federal government is paying for the entire expansion through 2016, but ramps down its share to 90 percent by 2020.
Ballance said Republicans fear the federal government could further lower its share in the future, and that’s another reason to reject full expansion.
Hunter, a former state health official, said there’s no evidence that the feds would go back on their promise: “The federal government has never reneged on its promise to pay the federal matching rate.”
The GOP plan also includes bills that would audit welfare programs, to ensure that people are not getting benefits improperly, and limit eligibility of the food stamp program.
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