HELENA – Some legislative Republicans and others are scrambling to come up with an alternative to Medicaid expansion, instead using public funds to help uninsured, low-income Montanans buy private health insurance.
Yet with just 14 working days remaining until the Legislature is scheduled to adjourn, those working on the proposals say time is getting short.
“Each day that goes by makes it more likely that it won’t succeed, because of procedural problems,” said Sen. Dave Wanzenried, D-Missoula, a sponsor of a Medicaid-expansion bill.
The alternatives would be in place of Democratic Gov. Steve Bullock’s proposal to expand Medicaid to extend federally funded coverage to 70,000 low-income Montanans starting next year – a proposal that the Republican-controlled Legislature has resisted.
Jim Molloy, a top adviser to the governor, said Thursday the governor’s office has met with some legislators working on alternatives, and that Bullock “is willing to consider any proposals that will provide coverage for uninsured Montanans and do so in a way that begins to reform our health-care delivery system and puts Montana’s tax dollars to work creating good-paying jobs in our state.”
“The governor has made it clear that expanding access to health coverage for Montanans is the only sensible thing to do,” Molloy said.
One of the alternatives would use the federal Medicaid funds to help poor people buy private health insurance, starting in 2014.
But a House Republican leader also said Thursday that many members of his caucus, which has a 61-member majority, aren’t likely to agree to any proposal that uses taxpayer dollars to expand health coverage for the poor.
House Majority Leader Gordon Vance, R-Bozeman, said the money should come from another source, such as settlement funds from a pending merger of the state’s largest health insurer, Blue Cross and Blue Shield of Montana, and a health-insurance corporation in Illinois.
Nonetheless, several Senate Republicans and others are working on alternative proposals that would use taxpayer money to finance private health coverage for poor Montanans currently without insurance.
One plan is likely to be folded into House Bill 623, which will be heard Friday before the Senate Public Health committee.
Sen. Ed Buttrey, R-Great Falls, said money inserted into HB623 would fund grants for people earning less than 100 percent of the federal poverty level – $11,500 for a single person – to help them qualify to buy private health insurance on the new, federal health insurance exchange next year.
Those who buy insurance on the exchange, an Internet marketplace, get federal subsidies to help them pay for the coverage.
“At 100 percent of the poverty level, (insurance) on the exchange is almost free,” Buttrey said. “The subsidy almost pays for the entire cost.”
Buttrey said Wednesday he hasn’t settled yet on the source of the bill’s funding.
A second alternative would be inserted into Senate Bill 395, Wanzenried’s Medicaid-expansion bill that passed the Senate a week ago.
SB395 is scheduled for a hearing Monday in the House Human Services Committee, a Republican-controlled panel that blocked the governor’s Medicaid-expansion bill on March 27.
Wanzenried said the plan is to amend his bill so federal Medicaid funds would be used to help poor Montanans without coverage buy private health coverage, on the health insurance exchanges.
A similar plan has been proposed in Arkansas and federal health-care officials gave it preliminary approval, but the approval isn’t final.
“If it has the same effect of qualifying people to be on the exchange, and they get coverage, I’ll support it,” Wanzenried said.
However, the bills are rapidly approaching deadlines that require them to be amended and debated and approved by the floor of their respective chamber by next Thursday.
House Minority Leader Chuck Hunter, D-Helena – the sponsor of Bullock’s Medicaid proposal – said Thursday he still sees long odds for getting any sort of Medicaid-expansion proposal passed, but that it’s not impossible.
“I’d say the chance is better than zero,” he said. “I wouldn’t put it at 50-50, but I’d certainly put it at a higher percentage than I would have two weeks ago.”