Coalition of health care, labor, policy groups to launch Medicaid-expansion initiative

Foes say they welcome debate; Essmann calls effort 'bad policy'
2013-06-26T10:32:00Z 2013-06-27T16:09:46Z Coalition of health care, labor, policy groups to launch Medicaid-expansion initiativeBy MIKE DENNISON Gazette State Bureau The Billings Gazette
June 26, 2013 10:32 am  • 

HELENA — A coalition of labor, health and advocacy groups took the first step Wednesday toward putting a voter initiative on Montana’s 2014 ballot to expand Medicaid coverage to 70,000 low-income Montanans.

The groups created a ballot committee called Healthy Montana Initiative, which will lead an effort to qualify the initiative for the ballot and campaign for its passage.

“We’re confident that we can qualify this for the ballot,” said Kim Abbott, president of the committee and co-director of the Montana Human Rights Network in Helena. “We know that Montanans care about their neighbors, and we feel that Montanans know that this is the right thing to do.”

The initiative would ask Montanans whether they want to expand Medicaid, the state-federal program that pays medical bills for the poor, to cover anyone earning up to 138 percent of the federal poverty level.

That’s about $15,900 for a single person and $32,500 for a family of four.

Under the Affordable Care Act, also known as “Obamacare,” states have the option to expand Medicaid starting in 2014. The federal government would pay for nearly all costs of the expansion through 2016, and then ramp down its share to 90 percent by 2020.

Montana Gov. Steve Bullock, a Democrat, this year proposed expanding Medicaid in Montana, but the 2013 Legislature rejected the expansion.

Conservative Republican lawmakers said it would end up being a costly expansion of medical welfare. They bottled the bills up in committee and killed a last-ditch effort to bring a compromise bill to the floor of the House in late April.

The coalition behind the initiative includes AARP Montana, the Montana Nurses Association, MEA-MFT, which is the state’s largest labor union, the Montana AFL-CIO, the Montana Primary Care Association and the Association of Montana Public Health Officials.

Kevin O’Brien, deputy chief of staff for Bullock, said Wednesday the governor wants to see the language of the ballot measure before deciding whether to support it. O’Brien noted that Bullock has said he’s open to any solution to expand health coverage “with or without the Legislature.”

Opponents of Medicaid expansion vowed Wednesday to fight the effort and said they welcome the public debate.

“If the press does a good job of fully reporting both sides of this debate, I think it’s possible that voters on Montana will decide they do not want Medicaid expansion,” said Joe Balyeat, state director of Americans for Prosperity, a free-market group.

Balyeat said the cost is enormous, and there’s evidence that expanding Medicaid doesn’t improve health care.

Senate President Jeff Essmann, R-Billings, said there’s a reason the Legislature rejected the expansion: “It’s bad policy. … It’s a whole lot of money for the state of Montana, and it doesn’t work.”

While voters could authorize Medicaid expansion through the initiative, a ballot measure cannot directly appropriate money. The 2015 Legislature would still have to approve both the federal and state funding.

Abbott said supporters of the measure believe that if it gets strong voter support, lawmakers would be compelled to authorize the money even if they oppose the expansion.

She said the group expects it will need “a significant investment of resources” to get the measure on the ballot and pass it, and that there will be well-financed opposition.

The signatures of at least 24,175 registered Montana voters are needed qualify an initiative for the ballot. The deadline for turning in signatures is next June.

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