The debate this week in Helena about offering Medicaid coverage to Montanans making less than $15,400 a year should be about reform and jobs.

Montana health care providers who serve low-income and uninsured citizens struggle to cover those costs by charging other patients and insurers more, thus pushing up insurance premiums. The system discourages people from getting preventive care and early treatment, forcing many who can’t pay to wait until their case is a costly hospital emergency. Patients often must navigate on their own, seeing doctors who don’t know the patient’s history and unnecessarily duplicate tests.

Montanans who fall through the cracks in our system are mainly adults working for low wages, according to the Montana Budget and Policy Center. Their problems getting timely health care can result in lost work days and lower productivity, too.

A study by the Bureau of Business and Economic Research at the University of Montana as well as U.S. Census Bureau surveys have estimated that about 69,000 Montanans would be newly eligible for Medicaid if it covered everyone whose income is below 138 percent of poverty level.

Gov. Steve Bullock proposes to cover those Montanans. His bill, introduced this month by House Minority Leader Chuck Hunter, includes:

  • A circuit breaker that would end the expanded program if federal support dropped below 90 percent of care costs.
  • Support for training more doctors in Montana.
  • Using the patient-centered medical home model to deliver better and more cost-effective care to Medicaid patients.
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In the Senate, Dave Wanzenried, D-Missoula, this week introduced a Medicaid reform bill that incorporates the patient-centered medical home and several other changes to make the program work better for patients while instituting cost-saving measures. Wanzenried’s bill was proposed by the Montana Hospital Association, which also represents nonprofit nursing homes and other Montana health care providers.

Montana business and economic development leaders have joined local hospitals, clinics, nurses, doctors and Montana AARP to support extending Medicaid coverage to low-income citizens.

Covering low-income citizens is good for their health and good for the state’s economy. The federal funds that would pay for care of the newly eligible will pump up the state economy, generating jobs in health care and supporting Montana businesses. The BBER estimates that serving 69,000 more Montanans through Medicaid would generate $477 million annually in labor income statewide. Those wages would be spent in every county and increase revenue for local and state governments.

In a letter to members of the House committee that will hold a hearing on the governor’s bill on Monday, Billings Chamber of Commerce and Big Sky Economic Development Authority leaders said:

“Currently, there are 7,245 uninsured adults in Yellowstone County who would be eligible for Medicaid if the proposed expansion passes. For Yellowstone County, this expansion has the potential to create over 1,400 jobs and generate approximately $60 million in labor income annually. These are dollars that will primarily be spent in Montana in general and Billings in particular. The total economic impact potentially could be two or three times greater.”

We join the chamber and EDA in supporting extending Medicaid coverage with “meaningful cost containment measures that would ensure we get better value for the tax dollars we spend.”

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