HELENA — Bills to expand Medicaid in Montana — one of Gov. Steve Bullock’s signature proposals — are likely dead in Republican-controlled committees at the Legislature, lawmakers close to the issue say.
If the panels vote to kill Medicaid expansion bills, the issue isn’t entirely dead — but it makes any road to approval much tougher for supporters of the expansion, which would extend government-funded health coverage to 70,000 low-income adults in Montana.
Bullock’s Medicaid expansion bill, House Bill 590, will be heard Monday in the House Human Services Committee, where Republicans hold a 10-6 majority.
GOP members of the committee, including its chairman, wouldn’t say definitively that the bill is a goner in the committee. But they made it clear it will be a tough sell to Republicans who generally oppose the Affordable Care Act and expanding government-funded health care.
“We’ve opposed the ACA all along,” said Rep. Cary Smith, R-Billings, the vice-chair of the committee. “Nobody has convinced me yet that the federal government taking over our health care was a good idea.”
Kevin O’Brien, deputy chief of staff for the governor, said Wednesday that Bullock believes if Medicaid expansion bills are given a “fair hearing” before the full Senate or House, members will pass “this job-creating and wellness measure.”
The ACA, the 2010 health care reform bill passed by Congress and signed by President Barack Obama, gives states the option of expanding Medicaid to cover citizens earning up to 138 percent of the federal poverty level, or $15,400 for a single person.
The feds will cover virtually all of the costs of the expansion from 2014 to 2016, and then gradually reduce support to 90 percent by 2020. It’s estimated the expansion would bring $750 million of federal funds into the state over the next two years.
In the state Senate, at least two Medicaid expansion bills are headed to the Senate Public Health Committee, which is controlled 4-3 by Republicans.
Its chairman, Sen. Jason Priest, R-Red Lodge, has proposed a bill to form a “select committee” of lawmakers and citizens that would study Medicaid expansion over the next two years — presuming that Medicaid expansion is rejected by the current Legislature.
Smith, who’s sponsoring the bill, said he believes an alternative path is needed to study the issue if the governor’s proposal is killed.
Sen. Dave Wanzenried, D-Missoula, the sponsor of a Medicaid expansion bill in the Senate, acknowledged Tuesday that it’s unlikely Republicans on the Senate committee will support the measure.
However, Wanzenried said he’s optimistic that the bill can somehow make it to the Senate floor for debate.
In the Senate, a simple majority can move a bill stalled in committee to the floor. Republicans hold a 29-21 edge in the Senate, so at least five Republicans would have to join all 21 Democrats to move the Medicaid bill from committee.
In the House, however, it takes 60 votes to extract a bill that has been tabled in committee and move it to the floor. Republicans hold a 61-39 majority in the House, so it would take 21 Republicans to join all 39 Democrats to remove a Medicaid bill from committee.
Staunch supporters of Medicaid expansion in the House say it’s been hard enough finding even 12 Republicans who might join the 39 Democrats to pass a bill if it gets to the floor — and that getting 60 votes is the longest of long shots.
“Getting the 12 has been tough,” said Rep. Pat Noonan, D-Ramsay. “I think the governor has done some good stuff in getting out and touting the benefits of (Medicaid expansion). We’ll see if any of that works, in the end.”
Bullock has been traveling the state, talking about Medicaid expansion, and is in Billings and Red Lodge on Thursday, visiting hospitals and clinics.
But legislative Republicans are questioning why Bullock didn’t start the conversation with them earlier in the session, noting that the governor didn’t even have a bill ready until last week.
“They brought it forward at the last minute,” said Rep. Scott Reichner, R-Bigfork, who’s also working on an alternative proposal. “Why not do a better job of selling it to the Legislature?”
“I’m looking at it and saying, with the late date … I don’t know if we can get a decent bill together before the session is over,” Smith added.
O’Brien said the governor had conversations with “hundreds of folks from across the state” who helped develop ideas in the bill, and that it wasn’t wise to rush it forward.
Bullock also has the power to put the issue on the floor of the House and Senate with an amendatory veto, folding the Medicaid expansion into another bill and sending it back to the Legislature for an up-or-down vote. However, O’Brien said the governor doesn’t believe that will be necessary.