Schweitzer: State employee clinics could eventually handle Medicaid expansion

2012-02-26T00:00:00Z Schweitzer: State employee clinics could eventually handle Medicaid expansionBy MIKE DENNISON Gazette State Bureau The Billings Gazette
February 26, 2012 12:00 am  • 

HELENA — If the Schweitzer administration’s plan for a low-cost health clinic for state employees gets off the ground this year, it could be expanded later to serve University System employees and maybe even Medicaid patients, Gov. Brian Schweitzer said last week.

“Now we’re talking about one-third to 40 percent of all the people in Montana who would be in this pool,” he said in an interview. “We’re going to get more extensive health care and it will be less costly.”

But if the long-term plan pans out, it will have to be without Schweitzer as governor. His final term expires in January, because term limits prevent him from running for re-election.

The administration is asking for bids from potential clinic operators to set up an initial Helena clinic, which would serve the area’s 16,000 state workers and their dependents who are covered by the state-employee health plan.

Bids are due April 9, and at a pre-bid conference last week, more than two dozen people attended, including representatives of Billings Clinic, St. Peter’s Hospital in Helena, Benefis Hospital in Great Falls, health-benefit manager Employee Benefit Management Services of Billings, the Cooperative Health Center in Helena and others.

Schweitzer hopes to award the contract this year and have the clinic operating by December, weeks before he leaves office.

The contract for the clinic, funded by the state-employee health plan, would run through 2015. The governor said he doesn’t need legislative approval to execute the contract.

When asked how future administrations and legislatures might react to the clinic, Schweitzer said he sees no reason why they wouldn’t embrace it, for it will save the state money over the long run.

“If they decide they want to spend more money on health care, they can,” he said. “They’d have to explain that to the people of Montana.”

Schweitzer said he didn’t propose the plan earlier because he wanted to see what the federal health reform law looked like and how it would work.

While the federal law has some good things, he said, it does not control health care costs — and that’s what the clinic would do, by providing low-cost primary care with medical staffers who are paid by salary rather than by the number of procedures they order.

The governor also said if more such state-sponsored clinics are opened around the state, they also could eventually see patients on Medicaid, the state-federal program that provides health coverage for the poor.

The federal law expands Medicaid in 2014 to cover anyone who earns up to 133 percent of the federal poverty level, a move that would almost double Montana’s Medicaid population, up to as many as 200,000 people.

Schweitzer said he fears the expansion could bust the state budget, and that sending Medicaid patients to the low-cost clinics could help mitigate those costs.

He also acknowledged that sending Medicaid patients to the clinics would require approval by the federal government, which has said it won’t consider such changes until 2017. Schweitzer said a bill stalled before Congress would allow asking for that approval earlier.

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