A Missoula surgeon and outspoken critic of the federal health care law says Montana should embrace the law’s Medicaid expansion, because it’s probably the only way thousands of low-income Montanans can get health coverage in the current marketplace.
Carter Beck, a neurosurgeon in private practice, said he remains opposed to the Affordable Care Act, the 2010 health reform law supported by President Barack Obama and congressional Democrats.
But in an interview Friday, he said the ACA is “the law of the land for the foreseeable future,” and alternatives that he believes could have made health insurance more affordable for individuals aren’t going to happen.
“The possibility for a low-income Montanan to afford health insurance on a self-funded basis is lost,” he said. “For that reason, I think it’s imperative that we expand Medicaid.”
Medicaid is the state-federal program that provides medical coverage for the poor. It currently covers about 100,000 Montanans.
Under the Affordable Care Act, states have the option to expand Medicaid in 2014 to cover all people who earn up to 138 percent of the federal poverty level, or about $15,400 a year for a single person. In Montana, it’s estimated the expansion would cover an additional 70,000 people.
The federal government has promised to cover nearly all costs of the expansion through 2016, and then gradually reduce its share to 90 percent of the costs by 2020.
Medicaid expansion can’t occur without approval of the Montana Legislature. Gov. Steve Bullock, a Democrat, is asking the current Legislature to approve the expansion, but has yet to present an expansion bill to lawmakers.
Republicans control majorities at the Montana Legislature. So far, not a single Republican lawmaker has come out publicly in support of Medicaid expansion.
Beck said he’s been trying to persuade Republicans in the Legislature to consider expanding Medicaid, and that it’s the right thing to do, to provide coverage for low-income Montanans.
“I agree with (Republicans) that the federal government doesn’t have the money,” he said. “But in the near term, with Montana being 49th in per-capita income, we can’t afford to stand on principle. We can’t afford to be a martyr for the cause.”
Those who would be covered by the Medicaid expansion are low wage-earners, some of whom work two jobs to make ends meet, Beck said: “For them to buy a (health insurance) policy in Montana would exhaust their disposable income.”
In the past two-and-a-half years, Beck has often spoken out against the Affordable Care Act. He was a Montana spokesman for the Coalition to Protect Patient Rights, a conservative group that opposed the ACA, has lectured at various groups around the state, and appeared on numerous media outlets.
Beck said he would have preferred to reform the medical liability system, lessen government involvement in health care, and enable consumers to be more involved in paying for their care, to exert market pressure on health care costs.
That approach lost out, however, and the direction taken by Obama and Congress was confirmed in the last election, he said.
“The dye has been cast and the success or failure of the ACA should be judged in its entirety, rather than judged by how it’s opposed by conservatives,” he said.