Montana’s Republican-led legislature and GOP governor are facing a critical decision regarding the state’s Medicaid expansion program. With the program set to expire this summer, lawmakers must decide whether to extend it beyond the scheduled end date of June 30. Despite uncertainties at the federal level, including potential changes to Medicaid under the Trump administration, Montana appears poised to keep the expansion program in place.
The House of Representatives in Montana recently passed a bill to make the Medicaid expansion program permanent by a vote of 63-37. The bill has also passed the first of two votes required for Senate approval. Governor Greg Gianforte has not publicly stated whether he would sign the bill, but he has expressed support for the program to continue with strong work requirements in place.
The federal government currently covers 90% of the health care costs for expansion enrollees in Montana, who are adults aged 19 to 64 with incomes at or below 138% of the federal poverty level. However, proposed federal budget cuts could impact Medicaid funding, potentially shifting significant costs to the states. If the federal matching rate drops, states like Montana may need to raise revenue or cut spending elsewhere to maintain the same level of Medicaid coverage.
In response to these potential changes, some states are considering legislation to prepare for a decrease in federal support for Medicaid expansion. Montana has trigger laws that could end the expansion program if the federal contribution rate drops. State Senate President Matt Regier introduced a bill to limit the expansion population and give the state health agency authority to control spending or enhance program integrity.
While there are differing opinions on how best to navigate potential federal changes, lawmakers in Montana are focused on ensuring the continued coverage of Medicaid expansion enrollees. Regardless of the outcome at the federal level, Montana’s legislators are working to find solutions that will allow the program to adapt to any future changes in Medicaid policy. As discussions continue, the importance of Medicaid expansion to the state’s population remains a top priority for lawmakers and officials alike.
