Montana officials debate House Republicans’ health-care proposal

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U.S. House Republicans this week released a draft plan to unthread former President Barack Obama’s health-care law and restructure Medicaid for low-income people. As politicians take their stances on the legislation, it’s unclear how — or if — it will unfold and what it could mean for Montanans.

Bryce Ward, a health economist with the University of Montana, said the federal legislation would roll back the government’s role in helping people afford health coverage. He believes it would also likely make insurance more expensive for some and inaccessible for millions.

However, Ward said he doesn’t expect the plan as it currently stands to survive.

“There’s still a lot of steps to go through, and a lot of disagreement among Republicans on what government’s role in health care should look like,” he said. “Maybe there’s some magic plan out there that’s the perfect compromise, but it seems like right now everybody is really far apart.”

He said it will be hard for Republicans to find that compromise when some don’t believe the plan goes far enough to support people who found health coverage through the Affordable Care Act. He said other lawmakers feel like the draft plan goes too far in weaving government with health care assistance.

Ward said that gap continues to leave Montanans uncertain of what coverage would look like if Congress repeals or replaces the nation’s current health care law.

THE AFFORDABLE Care Act, also known as “Obamacare,” allowed states to extend Medicaid coverage to adults with incomes up to 138 percent of the federal poverty line.

Since Montana tapped into the federal Medicaid expansion in 2015, more than 71,000 Montanans have signed up for Medicaid coverage, according to a report released by the Montana Healthcare Foundation on Monday.

The independent report commissioned by the foundation revealed more than 30,000 Montana adults have used that coverage for preventive care.

So far, 31 states have enrolled in the expansion.

The new GOP plan released Monday would overhaul the current Medicaid system, changing from open-ended federal funding to a cap based on enrollment and costs in each state.

In states that expanded Medicaid under the ACA, the government would continue to pay for the majority of the cost of the expansion through 2020.

After that, states adding Medicaid recipients would no longer receive the additional federal funds.

“But there’s a group of people demanding that the Medicaid expansion portion be cut,” Ward said. “And until you have something that’s passed or not, that’s still on the table.”

Montana could lose more than $284 million in health care funding if Congress repeals the Medicaid expansion tied to the Affordable Care Act, according to the report released by the Montana Healthcare Foundation.

Gov. Steve Bullock said during a Monday interview that there’s still too much uncertainty wrapped around the act for Montanans to make “rash moves based on what Congress may or may not do.”

“The first step is to see what happens,” Bullock said. “It would be irresponsible to repeal the ACA without a replacement — and it’s not just a guy like me. Republican governors around the country are saying the difference it’s made.”

Four Republican senators sent a letter to Senate Majority Leader Mitch McConnell on Monday voicing their concern that a “poorly timed” change in the current Medicaid funding structure could reduce access to life-saving services.

“While we support efforts to repeal and replace the Affordable Care Act and make structural reforms to the Medicaid program, we are concerned that the February 10th draft proposal from the House of Representatives does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states,” the senators wrote.

A PANEL of Montana lawmakers, state officials and insurance company representatives plan to meet to discuss the Republican measure to replace the Affordable Care Act, according to reports from the Associated Press.

Senate Majority Leader Fred Thomas, a Stevensville Republican, said the group will meet Thursday at 3 p.m. in the Capitol to discuss the measure and what the state would need to do to comply.

Thomas told the Associated Press he thinks the legislation doesn’t go far enough, though he said he wants to review the measure more closely before speaking about it in detail.

Ward said he expects the legislation will be up for debate for a while.

“Until its out of committee, actually up for votes in both chambers and appears to have the votes to pass, it’s hard to get too worked up about this bill,” Ward said. “There’s just still not a lot of certainty of what will happen.”

Reporter Katheryn Houghton may be reached at 758-4436 or by email at

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