Ignoring for the moment whether the State of Montana even needs to make substantial cuts in its budget, it is important to look carefully at what we choose to cut. The IR has done a decent job outlining some of the main points of contention here.
The one that troubles me the most, because it seems so unproductive, is eliminating something called presumptive eligibility and returning Federal dollars for health care for children. Republicans are cutting 26 million dollars, most of it federal, from the Healthy Montana Kids program. That probably won’t be a problem, because they are also cutting Presumptive Eligibility, a program whose elimination is expected to reduce sign ups.
It is that part that I find particularly troubling, because I have seen the difficulty involved in enrolling a child in HMK, as well as the medical difficulties that result from delaying medical care because a family doesn’t have insurance. Presumptive eligibility is especially important because lower-income kids like those eligible for this program frequently come from complicated circumstances that can make their eligibility difficult to determine – living with family members besides parents, having complicated guardianship situations, etc.
This may end adding more people to the qualified rolls, or temporarily qualifying kids who end up not actually being qualified (for about a month, mind you). However, if there is extra money available, this is a good use for it. The alternative is kids delaying medical care while they wait to be approved into the program, frequently raising the overall costs they incur by waiting until conditions are more serious.
More information on HMK is available here.