Medicaid-expansion initiative delayed again, as AG Tim Fox warns of legal problem

2014-01-23T10:32:00Z 2014-05-29T17:00:14Z Medicaid-expansion initiative delayed again, as AG Tim Fox warns of legal problemBy MIKE DENNISON Gazette State Bureau The Billings Gazette
January 23, 2014 10:32 am  • 

HELENA — Backers of a proposed 2014 voter-initiative to expand Medicaid coverage to at least 70,000 low-income Montanans have hit another delay, after Attorney General Tim Fox this week noted a legal problem with the measure.

Fox’s warning about problems with the initiative’s effective date prompted backers to resubmit a new version late Wednesday, delaying for another few weeks their efforts to get the initiative on the 2014 November ballot.

It’s the second time in two months that supporters of the Medicaid-expansion initiative have had to resubmit new language to state officials for legal review, which must occur before they can start gathering signatures needed to qualify the measure for the ballot.

Despite the delays, Kim Abbott, president of the Healthy Montana Initiative, said Thursday her group remains confident they can gather the minimum 24,175 signatures of registered voters to get the measure on the ballot. The deadline for submitting the signatures is June 20.

“There is so much energy around the state (on this issue),” she said. “We have the commitment of so many Montanans.

“We’re confident we can communicate with voters about the importance of this, in the time frame that we have.”

The initiative, if approved by voters, would expand Medicaid coverage to at least 70,000 low-income Montanans, and possibly as many as 100,000.

However, a ballot measure cannot appropriate money. If Montana voters approved the expansion, it still couldn’t occur unless the 2015 Montana Legislature voted to authorize spending the money — most of which would be federal funds.

Fox said the proposed measure’s effective date — “upon passage and approval” — creates an illegal appropriation of money if approved, because it would start spending money in November, before the Legislature could meet in January 2015.

Abbott said backers disagreed with Fox’s opinion, saying because a ballot measure cannot appropriate money, the effective date of

Nov. 4 would not actually spend the money.

Yet Abbott said backers would have had to go to court to overrule an opinion by Fox, and chose instead to refile the measure with a July 1, 2015, effective date.

Medicaid is the state-federal program that pays medical bills for the poor. Under the federal Affordable Care Act — the 2010 health-reform law known as “Obamacare” — states were required to expand Medicaid beginning in 2014.

The expansion would cover any household earning up to 138 percent of the federal poverty level, about $15,800 for a single person and $32,500 for a family of four.

A 2012 U.S. Supreme Court ruling, however, made the Medicaid expansion optional for states, and Montana’s 2013 Legislature rejected the expansion.

Supporters of the expansion, including health-care groups, unions and advocates for the poor, decided late last year to attempt to take the issue to Montana voters, through a ballot measure in 2014.

Gov. Steve Bullock, a Democrat who proposed the Medicaid expansion during the 2013 Legislature, has said he supports the ballot-measure effort.

His budget office also has estimated that nearly 100,000 Montanans would be eligible for Medicaid under the expansion and that an expansion would bring more than $900 million of federal funds to the state in 2015 and 2016.

The state’s share of funding the expansion would be about $26 million for those years, but would increase slightly in following years, as the feds slightly reduce their share of the cost.

Opponents, including leaders of the Montana Republican Party, say the expansion will end up costing the state more money down the road and is a needless expansion of “Obamacare.”

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