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Each session the Montana Legislature tackles hundreds of hard choices about policy and spending priorities. The 2019 session is no different.

In 2015, the Legislature made a once-in-a-generation decision to expand access to the Medicaid insurance program in an effort to reduce the number of low-income Montanans who were uninsured. At the time, one in every five Montanans was uninsured. Last year, fewer than 8 percent of Montanans were uninsured.

Now, after three full years of operation, the Legislature faces two tasks: deciding whether to reauthorize the program and how to fund it if they reauthorize it.

At the end of 2018 about 95,000 Montanans — roughly the combined populations of Missoula and Kalispell — were enrolled in expanded Medicaid, according to the Montana Department of Public Health and Human Services, which administers Montana’s Medicaid program. If the program is not continued, these Montanans will lose health insurance coverage starting in July of 2019, and their access to ongoing health care will be limited.

Who is covered by expanded Medicaid? Seventy percent of recipients work. Eighty percent live in a working family. Those who are not working are ill or disabled, a caregiver for other family members, in school or looking for work. Eighty-nine percent earn less than $12,140 a year.

Here’s why every Montanan should care about expanded Medicaid:

  • To remain financially solvent, health care providers pass along the costs of treating uninsured patients to insured patients. The practice, often called “cost shifting,” can amount to tens of millions of dollars every year. Expansion of Medicaid has dramatically reduced cost shifting. Insured patients subsidize fewer uninsured patients. At RiverStone Health Clinic, the payer mix has changed substantially. Before Medicaid was expanded, nearly half of RiverStone Health's patients were uninsured. Now, only 20 percent are uninsured.
  • Expanded Medicaid has saved lives. Of the 7,643 women who received breast cancer screening since the program started, 107 were diagnosed with breast cancer and are now being treated.
  • Expanded Medicaid has given the chance for previously uninsured Montanans to live healthier lives. Your friends and neighbors can now seek routine, preventive care and treatment rather than waiting until small medical challenges mushroom into dire, life-and-death emergencies.
  • Expanded Medicaid has preserved access to health care in rural areas and has stimulated job creation across the state. Because the 2015 legislature expanded Medicaid, critical access hospitals in our rural communities are 600 percent less likely to close and 5,000 new jobs were created.
  • A healthy population translates into a healthy, productive workforce, which allows companies to remain competitive.
  • Expanded Medicaid is good for small business. Thirty percent of the businesses in every Montana county employ Medicaid recipients. Over half of the state’s construction firms and nearly 90 percent of employers in the food service and accommodations industries have workers enrolled in Montana Medicaid.

In three short years, expanded Medicaid has demonstrated its value to workers and businesses. Medicaid recipients, health care providers, employers and other Montanans are watching and making their voices heard as lawmakers, who enjoy publicly financed health insurance, weigh the benefits and costs of this critical decision.

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Barbara Schneeman is the Vice President of communication & public affairs for RiverStone Health. She can be reached at Barbara.sch@riverstonehealth.org or 406.247.3200.

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