Health Care Montana Legislature Montana Politics

Legislative Hearing Makes It Clear that Montana Should Make Medicaid Expansion Permanent (Live Updates)

(Please forgive the stream-of-consciousness nature of this post. I’m writing as the hearing goes on, but chose to write in past tense so the post will make more sense in the future. Thanks.)

Today is the big day at the Montana Legislature, as the body listens to testimony about HB 425, the bill to make Medicaid expansion permanent in Montana.

The testimony in favor of Medicaid expansion was personal, powerful, and policy-driven.

Doctors testified about Montanans who were able to, for the first time, get access to dental care that made them happier, healthier, and more employable. They spoke of patients who were able to get access to substance abuse treatment, resolve their underlying health issues, and then become more productive members of society.

CEOs of health care providers spoke of how Medicaid expansion has provided jobs and protected smaller Montana hospitals and psychiatric care.

Officials from small counties noted that Medicaid expansion was critical to the continued viability of rural hospitals, noting that “Medicaid expansion made these rural hospitals economically viable” by providing certainty that medical care would be paid for in some of Montana’s poorest counties.

Speakers from Indian Country noted that Medicaid expansion has helped fund access to health care both on and off reservations by providing institutional support.

Veterans spoke of the 7,000 veterans in Montana who rely on Medicaid expansion, with one speaker noting the admonition of Romans 15:1 that it is the duty of the strong to help the weak.

Private insurance companies even spoke to the benefits of the bill, noting that it helps share risk and provide stability to the market.

The Montana Chamber of Commerce and organized labor, long known for their collaboration on most issues, spoke for the bill. 🙂

Many of those who spoke talked about how Medicaid expansion has provided access to mental health care, including transformative therapy and treatment that gave patients the ability to hold jobs, some for the first time in their adult lives.

Perhaps most importantly, patients talked about how their lives changed for the better as a result of Medicaid expansion. “With health insurance,” said one, she was able to “return to school, work, and drive again.” Another, a future nurse, noted that she “could not live” without Medicaid expansion, noting the incredible costs of medical treatment for her diabetes.

And, of course, the facts bear out this testimony. As we have noted before, Medicaid expansion not only saves lives, but it has actually created jobs and boosted the economy, all while saving the state money:

Medicaid expansion will bring about $350 million to $400 million in new spending to the state’s economy and add 5,000 jobs in health care and other industries that pay $270 million by 2020, according to the report.

In its first year, 2016, the state saved spent $5.3 million on benefits and claims and to administer Medicaid expansion. That same year, savings were $18 million. The third part of the picture, which advocates are calling attention to, is increased revenues to the state in the form of more taxes paid on income from more jobs, higher spending on health care and industry grown, for example. That revenue was $22.2 million in 2016.

And then it was time for the opponents.

The first opponent got up to speak exemplified the absurdity of opposition to Medicaid expansion. He said that his son had received Medicaid, noted that his daughter received free care from the hospital in Bozeman and that another son received free drugs from a pharmaceutical company. One has to wonder who he imagines paid for those services in the end. He then discussed the need for more “community-based health care” and affordable options for health care, exactly what Medicaid expansion provides for Montana.

Known bigot Senator David Howard stood in opposition to Medicaid expansion to claim that Medicaid expansion represented dangerous socialism, referring to someplace he kept calling “Venzuela” as evidence.

Representative Brad Tschida, who noted that his niece deserved to receive government health care services while others don’t, claimed that he had as much empathy as anyone, despite spending his allotted speaking time claiming that “able-bodied” workers were gaming the system. This is a common theme among opponents to Medicaid expansion, the idea that they have a God-like capacity to determine who should have access to medical care and who should not.

Representative Derek Skees claimed, without any evidence, that the Medicaid program was riddled with fraud, asserting that people who aren’t residents are receiving coverage and that college students are “edging out” the disabled.

It’s fascinating that Republican legislators either seemed unwilling to let members of the public speak on the bill or unable to find any, as Senator Howard and Representatives Noland, Skees and Howard consumed much of the time available for testimony.

These speakers and “free market think tank” advocates kept referring to the failure of I-185, without noting that tobacco companies spent in excess of $17 million to oppose the initiative.

Another speaker, who acknowledged that she receives “great health care” from a state-funded college, argued that it was unconstitutional for the government to provide health care. Hope she’s not a professor.

The huge amount of time spent by legislators aside, what was most striking about the testimony of opponents was that most acknowledged that Medicaid is an effective program, but all of those speakers seemed to believe that they, like Representative Tschida, own some sort of special insight about who “deserves” access to health care and believe in the myth that the “free market” will somehow drive down costs for people.

If you appreciate an independent voice holding Montana politicians accountable and informing voters, and you can throw a few dollars a month our way, we would certainly appreciate it.

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Don Pogreba

Don Pogreba is an eighteen-year teacher of English, former debate coach, and loyal, if often sad, fan of the San Diego Padres and Portland Timbers. He spends far too many hours of his life working at school and on his small business, Big Sky Debate.
His work has appeared in Politico and Rewire.
In the past few years, travel has become a priority, whether it's a road trip to some little town in Montana or a museum of culture in Ísafjörður, Iceland.

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