More than 38,000 previously uninsured Montanans have enrolled for health coverage from the state’s Medicaid expansion program — surpassing projections by thousands.

“There were a lot of skeptics, even from supporters, that this could move so quickly and so seamlessly,” Tara Veazey, the governor’s health policy adviser, said at a meeting Tuesday in Helena involving state officials and a legislative oversight committee.

State officials said they are especially encouraged by the number of young adults who have enrolled.

The expansion, also known as the HELP Act, was signed into law just over a year ago and is predicted to reach 45,000 Montanans by 2020.

Since the program rolled out Jan. 1, 38,298 Montanans have enrolled for health insurance under the expansion — more than 12,400 beyond the Department of Public Health and Human Services projection for the first year.

In Flathead County, 3,900 people have signed up.

Medicaid expansion was hotly debated during the last legislative session and won passage only after Democrats and Republicans hammered out a compromise that included a workforce component.

Jessica Rhoades of the Health and Human Services said that before the HELP Act, people weren’t eligible for Medicaid unless they had children living in their household. She said that left many people without aid until they entered drastic situations such as Stage 4 cancer.

Rhoades said the department’s most recent report on enrollees shows that the most vulnerable populations in the state are being reached.

Of those who have enrolled, 82 percent fall below the poverty line, roughly 12 percent have been American Indians and 46 percent have been between the ages of 19 and 34.

“This program is truly helping those who need it most,” she said, adding that it’s important to get people enrolled now.

Previously, Montana paid 34 percent of Medicaid costs. However, federal dollars for now cover the total cost of the Medicaid expansion.

Starting in 2020, Montana will pay 10 percent of the cost and slowly continue to increase its financial obligation, Rhoades said.

“Many people who don’t have insurance have a pent-up need for health care,” Rhoades said. “We want to see strong enrollment like this so people’s pent-up needs are being met while we’re getting 100 percent of coverage.”

Marrie Matthews with the state health agency said the expansion has saved Montana’s general fund $3 million since federal funding has carried 100 percent of the cost.

She said the recent report also shows clients are taking responsibility for their health care. Roughly 68 percent of Medicaid clients have paid their premium bills in the last two months, which adds up to $367,000, Matthews said.

Lawmakers will need to reapprove the expansion in 2019 to keep Medicaid expansion from expiring.

Reporter Katheryn Houghton may be reached at 758-4436 or by email at [email protected].