FACT CHECKER: MEDICAID REFORM IN MONTANA
What the 2019 Medicaid Reform & Integrity Act does:
The Medicaid Reform and Integrity Act continues Medicaid coverage to certain low-income Montanans while adding measures to increase program accountability, improve transparency, and reduce financial burden on the state’s general fund. The Act established community engagement (paid or volunteer work) requirements for participants, revised eligibility verification procedures, and imposed a new tax on hospitals to help pay for the program.
What it does NOT do:
Make any changes to covered services, including abortion services or gender reassignment surgeries.
What Medicaid expansion does:
Medicaid expansion increases access to healthcare services for low-income Montanans. It offers government-sponsored health coverage (Medicaid) to Montanans whose household income is up to 138% of the Federal Poverty Level (FPL). It is designed to provide healthcare coverage to those in the “coverage gap.” Frequently, these are people who are working jobs that do not offer health insurance. They are not eligible for traditional Medicaid and many are not allowed to buy health insurance from the health exchange. In Montana, a family of four earning $35,535 or less (per 2020 guidelines) would qualify. Roughly 1 out of every 10 Montanans receives healthcare services through Medicaid expansion.
In addition to providing essential healthcare services to Montanans, Medicaid expansion has significant economic benefits, too. Following its passage in Montana in 2015, Medicaid expansion added $600 million in annual economic output to Montana’s economy. It generated 9,715 new jobs, $793 million in associated wages and $30.5 million in new state tax revenue.
Montana businesses also benefit from Medicaid expansion. 3 in 5 Montana businesses have workers who receive healthcare through Medicaid expansion. Medicaid expansion has helped ensure a healthy workforce for 18,000 businesses without any additional taxes or contribution from the employer. Instead, the state taxes hospitals to generate the funds to cover Montana’s share to administer the program.
80 percent of Medicaid beneficiaries are in working families. Among those not working, over 1 in 3 are ill or disabled. Medicaid expansion has drastically reduced the rate of charity care, which helps keep our hospitals financially viable.
FACT CHECKING THE CLAIMS: MEDICAID REFORM IN MONTANA
THE CLAIM: The 2019 Montana Medicaid
Reform bill increased abortion services.
THE TRUTH: The Medicaid Reform bill did not change any of the healthcare services covered by Medicaid. Federal statute (law) provides for the services the state can cover under its Medicaid plan. In fact, federal law prohibits federal funds from being used for abortion services except in the limited cases of rape, incest, or if a woman suffers from a life-threatening physical injury or illness that would place the woman in danger of death unless an abortion is performed. The Montana Medicaid Reform and Integrity Act 2019 took measures to increase accountability and transparency in the administering of Medicaid expansion in Montana and cannot change federal law.
"It is regrettable, however, that some are accusing those brave lawmakers who stood with us that their support of Medicaid reform meant that taxpayer-funded abortions would occur under the legislation. This is false. As a non-profit Catholic healthcare organization and consistent with our ethical and religious directives, Holy Rosary Healthcare does not perform abortions in our facility. Indeed, we would not have supported the Medicaid reform legislation last session if it provided for taxpayer-funded abortions. Those who argue otherwise are incorrect.”
THE CLAIM: Medicaid pays for procedures that aren’t medically necessary.
THE TRUTH: The Medicaid reform bill did not change any of the healthcare services covered by Medicaid, rather it reformed the existing program to increase accountability of the services offered and participants covered. Medicaid expansion is a federally-supported program administered by the state with 90% of funding provided by the federal government. As a result, covered services are defined at the federal level. Services and procedures provided to patients must meet the criteria of medically necessary and do not include any experimental or clinically unproven procedures. Medical necessity is determined clinical standards of care - not by lawmakers.
THE CLAIM: Legislators who worked to reform Medicaid should be punished.
THE TRUTH: A vote to reform the system was a vote to make Medicaid more transparent, accountable and effective. Like any piece of federal legislation, all Montanans expect their elected officials to work to represent them and make sure the law works in our unique state with our unique circumstances. Regrettably, most of the attacks on the legislators who rolled up their sleeves to reform the legislation are coming from individuals who are more interested in scoring political points and taking away healthcare coverage from working Montanans.
After Medicaid expansion was enacted in 2016, more than 90,000 Montanans had access to healthcare which provided an enormous benefit to Montana businesses – in fact, almost 60% of Montana businesses benefitted by having employees covered by the new Medicaid expansion. Those who aim to roll back Medicaid don’t seem to understand that it has created or sustained 9,700 Montana jobs, $793 million in new and sustained wages and created $2 billion in new economic activity since its passage. At a time when our nation is reeling from the economic and health ripple effects of COVID-19, access to healthcare and the viability of our healthcare providers are more critical than ever.
As Montana healthcare providers on the front line face the unprecedented strain of the COVID-19 pandemic, it’s important for Montanans to understand that the 2019 Medicaid Reform and Integrity Act was an essential piece of legislation in helping fortify our healthcare infrastructure.
THE CLAIM: Montanans voted down I-185 because they don’t support Medicaid.
THE TRUTH: The I-185 citizens’ initiative was two-fold: it attempted to increase tobacco taxes in order to finance Medicaid expansion.
Big Tobacco dumped unprecedented money into Montana in order to protect its bottom line. And it worked. However, the truth is: expanding healthcare isn’t a red or a blue issue: it’s a Montana value.
THE CLAIM: Medicaid is bad for Montana.
THE TRUTH: The economic benefits of Medicaid expansion have far and away exceeded costs. Medicaid expansion has added $600 million in economic output to Montana’s economy each year. It has fueled 9,715 new jobs, $793 million in associated wages and $30.5 million in new state tax revenue. 3 in 5 Montana employers have workers enrolled in Medicaid. Medicaid expansion has allowed tens of thousands of working Montanans to address pent-up healthcare needs. Access to healthcare services promotes a healthier workforce and strengthens the earning potential for individuals and families. Medicaid expansion in Montana has been a bipartisan success providing coverage for close to 90,000 Montanans who would have otherwise fallen in the coverage gap. 80 percent of Medicaid beneficiaries are in working families. Among those not working, over 1 in 3 are ill or disabled. Medicaid expansion has drastically reduced the need for charity care, which helps keep our hospitals financially viable.
THE CLAIM: We need leaders in the Montana legislature who will work toward commonsense solutions to our state’s healthcare needs.