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New GOP bill to expand Medicaid in Montana faces hurdles

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Buttrey Medicaid bill

Sen. Ed Buttrey, R-Great Falls, right, talks to reporters about his bill to expand Medicaid in Montana, introduced Tuesday. Buttrey said the bill has the potential to garner bipartisan support to expand Medicaid to 40,000 or more low-income Montanans. Joining him at the Capitol news conference in support of the bill were fellow Republicans senators, from left, Taylor Brown of Huntley, Bruce Tutvedt of Kalispell and Pat Connell of Hamilton.

HELENA – As a Republican state senator on Tuesday unveiled his plan to expand Medicaid coverage for thousands of low-income Montanans, he called it a “nonpartisan, long-term solution” that will provide health care and a “path out of poverty” for the poor.

But while Great Falls Sen. Ed Buttrey claims bipartisan support for his plan, it has considerable hurdles to clear before it takes effect.

A leader of GOP conservatives in the Legislature declared the plan to be “worse than the governor’s,” which House Republicans killed last week.

And Obama administration officials would have to sign off on the plan, which has some wrinkles that other states expanding Medicaid haven’t tried or had approved.

It also needs the signature of Democratic Gov. Steve Bullock – although Bullock indicated Tuesday that he’s willing to take a measured look at Buttrey’s plan, if it can get through the Republican-controlled Legislature.

“At the end of the day, this isn’t about whose bill is passed,” Bullock said in a statement. “It’s about bringing tax dollars home to expand health care to 70,000 Montanans and throw a lifeline to our rural hospitals.

“This bill would do just that. Montanans expect us to put partisanship aside and focus on solutions. That is what I’m committed to doing.”

Buttrey’s Senate Bill 405, like Bullock’s proposal, accepts federal money – as much as $700 million the next two years – to expand Medicaid to cover anyone earning up to 138 percent of the federal poverty line, an annual income of $16,200 for a single person.

However, unlike Bullock’s bill, it would charge those eligible an annual premium of 2 percent of their income. It also would charge them more money if the value of their assets exceeds a $250,000 house, one light vehicle and $50,000 in cash or cash equivalents.

The proposal also says those accepting the coverage can take part in a state program that aims to help them become employed or better employed so they can earn more money and get off the Medicaid health plan.

Federal health officials wouldn’t comment directly on the proposal Tuesday, but said they’re willing to work with states to design “programs uniquely their own,” as long as they comply with federal law and maintain essential health benefits.

Buttrey said he’s been talking to officials with the U.S. Centers for Medicare and Medicaid Services, which must approve any Medicaid expansion plan, and that they’ve been encouraging.

However, federal officials won’t approve anything that’s not in writing, and have been notoriously secretive about just what they may consider. The final decision is made by Obama administration officials in Washington, D.C.

But before Buttrey’s proposal gets to CMS, it first has to get through the Montana Legislature, which is controlled by Republicans, many of whom oppose full Medicaid expansion.

A dozen Republican lawmakers joined Buttrey at Tuesday’s news conference unveiling the bill, but the chairman of the House Human Services Committee, which killed the governor’s Medicaid bill, said Tuesday he considers Buttrey’s bill a non-starter.

“He’s using Republican-sounding words (to describe it), but when you look at the package, it’s centralized planning at its worst,” said Rep. Art Wittich, R-Bozeman. “It suffers from the same problems that the governor’s bill does, which is, you still create an entitlement that seems free to able-bodied adults.”

When asked how he planned to get the bill past Wittich’s committee, which is controlled by staunch opponents of a full expansion of Medicaid, Buttrey said only: “We hope that (the bill) goes to the right committee.”

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