As political sides circle on Medicaid expansion, many ask: Where’s the bill?

2013-01-31T22:15:00Z 2013-02-01T00:21:13Z As political sides circle on Medicaid expansion, many ask: Where’s the bill?By MIKE DENNISON Gazette State Bureau The Billings Gazette
January 31, 2013 10:15 pm  • 

HELENA — While Gov. Steve Bullock this week strongly pitched his plan to expand government health coverage for 70,000 low-income Montanans, his administration has yet to draft a bill to implement it — and supporters and opponents alike wonder when that will happen.

“If it’s one of the top spots in the governor’s agenda, I think it’s a bill he needs to bring forward,” House Speaker Mark Blasdel, R-Somers, said Thursday. “They need to bring forth their ideas.”

Four weeks into the 2013 Legislature, the Bullock administration has yet to even submit a bill proposal for drafting on the $750 million health care plan, or decide who will sponsor it.

Democratic House Minority Leader Chuck Hunter, who supports the plan, said this week he would like to see a bill soon but understands the issue is delicate and needs more work before a measure is drafted and introduced.

“I think a lot of the discussion between the parties has been on what a compromise could be … rather than just toss a bill out there and see it go down to defeat,” he said.

The plan — one of the session’s major issues — calls for expanding Medicaid, the state-federal health insurance plan for the poor, starting in 2014. The expansion would be financed almost entirely by the federal government for its first three years and offers coverage to all Montanans earning up to 138 percent of the federal poverty level, or $15,400 for a single person.

The Bullock administration estimates that the expansion would add 70,000 people to Medicaid and bring $750 million of federal money to the state in the next two years.

While legislative Democrats are solidly behind the plan, most Republicans, who control majorities at the Legislature, are not. They don’t want to increase federal spending, they fear the feds won’t keep paying for the expansion, and they don’t like the federal health care law that includes the expansion.

Any bill enacting the expansion is subject to approval by the Legislature and would start in the House, where the GOP has a 61-39 majority.

Kevin O’Brien, Bullock’s deputy chief of staff, said Thursday that the administration is working on a bill but doesn’t know when it will be introduced.

The administration is talking with legislators, business people and the health care industry about the proposal, he said.

“I think it’s still early in the process, and there will be plenty of time to make sure we can create a made-in-Montana solution that creates jobs and provides health insurance to thousands of Montanans,” O’Brien said.

John Flink, vice president of MHA, which represents Montana hospitals, said a panel of top hospital staffers from around Montana is working on a proposal that will expand Medicaid and address problems that drive up costs, like overuse of certain services and inappropriate use of hospital emergency rooms.

MHA and other medical groups support the expansion.

“We want to balance this and get the expanded coverage, but so it protects businesses, protects taxpayers and does it in a fiscally responsible way,” Flink said.

Lobbyists close to the issue say it will be a difficult task persuading enough Republicans to join Democrats to form a majority in support of the plan.

Still, Hunter said he senses that some Republican House members are receptive.

“When I first came here this session, what I heard from the other side of the aisle was, `Heck no, we’re not interested — no way, no how,’” he said. “Now, I feel a softening of positions among some folks in that party.”

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