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Max Naethe listens with his daughter Aliceia

Max Naethe, of Kalispell, who testified March 20 in favor of a bill to expand Medicaid coverage in Montana, listens with his 10-year-old daughter, Aliceia, to other testimony for Senate Bill 405 at the Capitol. Naethe said he needs a heart transplant and doesn’t earn enough money to get a subsidized policy but that he’d be covered by expanded Medicaid. In the foreground is the sponsor of the bill, Sen. Ed Buttrey, R-Great Falls.

Last week, a bipartisan majority of 28 Montana senators voted to make about 70,000 of their lowest-income constituents eligible for health care coverage.

Among lawmakers who stood up for the health of individuals and the state economy by voting for Senate Bill 405, we especially commend those representing Yellowstone County and Eastern Montana: Duane Ankney, Taylor Brown, Robyn Driscoll, Mary McNally, Sharon Stewart-Peregoy and Jonathan Windy Boy.

Coverage compromise

SB405 is a compromise introduced by Sen. Ed Buttrey, R-Great Falls. It would allow all Montanans whose income is less than 138 percent of poverty level to be covered by Medicaid, but would require them to pay premiums equal to 2 percent of their income and to also pay the highest copayments allowed by federal law. Unlike other Medicaid bills offered this session and in 2013, SB405 also would revise medical malpractice law to reduce the time period in which a lawsuit could be filed. The bill also requires the state to offer career counseling sessions to new Medicaid enrollees.

These requirements and others make Buttrey's bill more complex, but it also includes flexibility to serve the poorest and neediest Montanans. It's the only bill left this session that could cover a otherwise uninsured Montanans and draw down federal matching funds to cover 100 percent of care costs.

This bill, which Buttrey dubbed the Montana Health and Economic Livelihood Partnership Act (HELP), is scheduled for a hearing at 11 a.m. Tuesday before the House Health and Human Services Committee. That panel heard hundreds of Montanans testify in favor of the Healthy Montana Medicaid bill last month, only to end the public hearing by killing the bill.

SB405 must not meet the same fate. This bill must be debated on the House floor, so all 100 representatives have the opportunity to decide.

Seriously ill uninsured

The SB405 fiscal note estimates that about 45,000 eligible Montanans would choose to enroll in Medicaid during the first two years of the program as provided in SB405. Several thousand of those enrollees are likely to be seriously ill people who already receive some amount of state-funded health care, but SB405 would reduce the cost to the state treasury because the federal government would increase its share to 100 percent.

About 29,000 uninsured Montana adults have serious mental health or substance abuse disorders, according to the American Mental Health Counselors Association.

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In Billings, the Community Crisis Center fills up every night with indigent adults who have mental illnesses and chemical dependencies. Fewer than 20 percent have any means to pay for treatment, according to MarCee Neary, center manager.

"There's a lot of people out there who are in a gap who can't access services," said Lennette Kosovich, of chief executive officer at Rimrock. Medicaid "would open up doors for them."

Billings lawmakers should take note: If all low-income Montanans were eligible for Medicaid, those troubled folks on our downtown streets could get into treatment more quickly and Medicaid would help cover the costs.

"This is a Montana solution, unlike any other," Brown said before voting for SB405, which he said is a better bill than those presented in 2013.

"It's a lot of hard work from a lot of people," Buttrey said of SB405. "It's Montanans helping Montanans."

Members of the House should stand with the 28 senators who voted for all the Montanans who need mental health and addiction treatment they cannot afford, for all the low-wage workers who lack insurance, for our hospitals and community clinics that provide ever more uncompensated care each year. Let's get Montanans covered this year.

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Opinion Editor

Opinion editor for The Billings Gazette.