HELENA – Supporters of expanding Medicaid health coverage to 70,000 low-income Montanans submitted language Thursday for a 2014 ballot measure, which would take the issue directly to Montana voters.

“This didn’t get addressed at the last Legislature, so we’re looking forward to our citizens addressing it themselves,” said Lori Chovanak, executive director of the Montana Nurses Association.

The coalition of labor, health and citizen groups submitted to the secretary of state the initiative language, which is reviewed for legal compliance before backers can start gathering signature to place the measure on the 2014 ballot.

The “Healthy Montana Initiative,” if passed by voters, would expand Medicaid, the state-federal program that pays medical bills for the poor, to all Montanans who earn up to 138 percent of the federal poverty level.

For a single person, that income level is about $15,800. For a family of four, it’s $32,500.

The initiative says Montana will accept federal money that pays for nearly all of the cost of the expansion, starting July 2015.

However, a ballot measure cannot appropriate money. If the measure gets on the 2014 ballot and passes, the 2015 Montana Legislature still would have to approve the spending for the program expansion.

Kim Abbott, president of the Health Montana Initiative, said if Montanans pass the measure, she’s hopeful the Legislature will respect their wishes and approve the spending.

A majority of Republicans at the 2013 Montana Legislature successfully rejected Medicaid expansion, saying they opposed expansion of “Obamacare” and a program that would end up costing the state too much money.

Medicaid expansion is part of the 2010 Affordable Care Act, the federal health-reform law also known as Obamacare. The original law required all states to approve the expansion, but a 2012 U.S. Supreme Court decision made the expansion optional for states.

Under the law, the federal government pays for almost all the cost of expansion through 2016 and then reduces its share to 90 percent by 2020. The proposed initiative says if federal assistance drops below that level, Montana’s Medicaid expansion will be terminated.

Gov. Steve Bullock, a Democrat who proposed expanding Medicaid this year, supports the initiative effort, his office said.

“Unfortunately, a handful of legislators used procedural tricks to stop the measure – and now our taxpayer dollars are going to pay for health care in New Jersey and California, while Montanans get nothing,” said Kevin O’Brien, deputy chief of staff for the governor. “That needs to change.”

Bowen Greenwood, executive director of the Montana Republican Party, said the party likely would oppose the measure, if it gets on the ballot.

Americans for Prosperity-Montana, a free-market group that spoke against Medicaid expansion at the 2013 Legislature, also would probably “get information out as to why (expansion) is not a good idea for Montana,” said the group’s state director, Joe Balyeat.

Chovanak and Abbott said the expansion will bring billions of federal dollars into the state, new jobs and health care coverage for 70,000 people, most of whom can’t afford health insurance or health care.

“We’re hoping that Montanans will look at this, pass it, accept these federal dollars and strengthen our health-care system,” Chovanak said.

Backers will need the signatures of 24,175 registered Montana voters to get the measure on the 2014 ballot, as well as signatures from at least 5 percent of the voters in at least 34 of Montana’s 100 House districts. They have until next June to submit the signatures.

Missoulian State Bureau reporter Mike Dennison can be reached at 1-800-525-4920 or by email at mike.dennison@lee.net.

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