HELENA – Two Democratic state senators Tuesday dropped in a pair of new bills to extend federally funded Medicaid health coverage to an additional 70,000 low-income Montanans, saying the controversial issue should be debated in the Senate.
A Republican House member also said he’s working on a GOP alternative to the Medicaid expansion, to use state funds to help some low-income Montanans buy private health insurance.
Rep. Scott Reichner, R-Bigfork, said he plans to introduce his bill Wednesday.
“In the event that Medicaid expansion is rejected by the Legislature, (my bill) is an alternative,” Reichner said Tuesday evening.
Whether Montana expands Medicaid coverage in 2014, as part of the federal Affordable Care Act, has become one of the most contentious issues before the 2013 Montana Legislature.
Democratic Gov. Steve Bullock supports the expansion and has put forth a bill to enact it, but leaders of the Legislature’s Republican majorities have said they’re opposed. The expansion can’t occur without approval of the Legislature.
Under the ACA, the federal government would pay for nearly all costs of the expansion from 2014 to 2016, and then gradually reduce its payment of the costs to 90 percent by 2020.
On Tuesday, Sen. Dave Wanzenried, D-Missoula, introduced a Medicaid expansion bill that is supported and was drafted primarily by the state’s hospitals.
It would expand Medicaid coverage to people earning up 138 percent of the federal poverty level, as well as launch a number of reforms that the hospitals say could save money and use the private sector in the expansion.
For a single person, 138 percent of federal poverty level income is about $15,400.
Wanzenried also said he wants to have an alternative expansion bill in the Senate, should expansion bills in the House get killed.
“While there are bills in the House that deal with the same issue, the Senate needs to have a vehicle for the debate here,” he said Tuesday afternoon. “The public deserves that discussion.
“This bill provides an opportunity for a significant number of people, especially the hospitals, which are everywhere in Montana, to have an opportunity to talk about the expansion.“
Sen. Christine Kaufmann, D-Helena, also introduced a bill Tuesday that simply expands Medicaid coverage to those earning up to 138 percent of the federal poverty level, similar to a bill introduced last month by Rep. Pat Noonan, D-Ramsay.
The House Human Services Committee is scheduled to hear Noonan’s bill and a separate bill that includes Gov. Bullock’s proposal next Monday.
Hospital personnel have been working for several months on the bill introduced by Wanzenried.
It not only expands Medicaid to cover the 70,000 new people, but also directs the state to pursue several options that would involve private contractors or private insurers in administering the government-financed health coverage.
“We want the state to look at ways to implement the expansion in the private sector, without expanding the Medicaid infrastructure at the Department of Public Health and Human Services,” said John Flink, a vice president at MHA, the state association representing the hospitals.
Reichner’s bill also would involve private insurers to expand coverage for low-income Montanans, but wouldn’t use the federal money to expand Medicaid.
Instead, it would give poor, uninsured Montanans state funds that would help them buy subsidized, private health insurance through the new, federal insurance exchanges, which are Internet marketplaces scheduled to come on line later this year.
Reichner said he plans to use revenue from the pending buyout of Blue Cross and Blue Shield of Montana to pay for the plan.