Montana’s Medicaid expansion has significantly impacted healthcare access, especially on reservations. Previously, limited budgets led to critical shortages, but Medicaid now covers nearly 230,000 Montanans, improving health services and outcomes. The expansion, covering adults with incomes up to 133% of the federal poverty level, has been a financial boon, easing healthcare access on reservations and stretching Indian Health Service budgets. However, its future remains uncertain.
The program’s effects extend beyond just healthcare. Medicaid expansion is seen as an economical development tool, creating jobs and stimulating the economy. Economist Bryce Ward noted the expansion supports 6,000 to 8,000 jobs and generates significant economic activity. Medicaid’s cost to Montana’s general fund remains steady, despite covering 80,000 more people, due to federal reimbursements covering 79% of the program’s $2.4 billion cost in fiscal 2023.
Despite these benefits, the program faces opposition from conservative groups citing high costs and extensive coverage. The Foundation for Government Accountability argued against renewal, claiming it benefits healthcare providers more than patients. A “trigger law” could also end the expansion if federal funding decreases, affecting over 3 million adults in nine states, including Montana.
Montana’s Medicaid expansion is part of Gov. Gianforte’s budget proposal, but its future is in lawmakers’ hands. Without legislative action, it could sunset by June 2025. The program has reduced Montana’s uninsured rate from 16.4% in 2015 to 11.4% in 2022, with increased screenings for conditions like breast cancer and diabetes. Medicaid now covers more than one in five Montanans, including two in five children.
Counties like Glacier and Roosevelt, home to the Blackfeet and Fort Peck Reservations, have over half their populations covered by Medicaid. The expansion also provides preventative care, reducing life-threatening emergencies. The Montana Healthcare Foundation emphasized these benefits in a recent webinar, highlighting Medicaid’s broad reach and fiscal advantages amid ongoing debates.
