Montana Becomes 30th State To Expand Medicaid Under ACA
On Monday, federal health officials approved Montana's alternative Medicaid expansion plan, making the state the 30th to expand the program under the Affordable Care Act, the AP/Sacramento Bee reports.
According to the AP/Bee, Montana is the sixth state to expand Medicaid through a waiver that alters the traditional expansion criteria (Volz, AP/Sacramento Bee, 11/2).
Montana Gov. Steve Bullock (D) in April signed legislation (SB 405) that would expand Medicaid under the ACA to an additional 70,000 state residents. Montana was required to submit a waiver and obtain federal approval for its alternative expansion plan because it includes non-traditional Medicaid components, such as monthly premiums for beneficiaries.
The plan -- called the Montana Health and Economic Livelihood Partnership Act and introduced by state Sen. Ed Buttrey (R) -- will use federal funding to expand Medicaid to state residents with annual incomes of up to 138% of the federal poverty level.
The plan will require Medicaid beneficiaries with incomes that are 50% of FPL or higher to pay premiums for their coverage (Radnofsky, Wall Street Journal, 11/2). The monthly premiums will cost 2% of beneficiaries' incomes. In addition, the plan will:
- Have the state attempt to collect debts from beneficiaries who do not pay their premiums;
- Require beneficiaries to contribute copayments for particular services;
- Potentially terminate coverage for individuals with incomes between 100% and 138% of the federal poverty level who do not pay their premiums;
- Not terminate coverage for individuals with incomes below 100% for not paying premiums;
- Ask enrollees to participate in a voluntary workplace assessment survey designed to help them with job placement;
- Be administrated by Blue Cross and Blue Shield of Montana (AP/Sacramento Bee, 11/2); and
- Sunset after four years, at which point the state Legislature would have the option to renew the measure.
According to the Journal, individuals who qualify for the expanded program can start enrolling immediately. Coverage under the program will take effect Jan. 1, 2016 (Wall Street Journal, 11/2).
While 70,000 Montana residents are estimated to qualify for coverage under the expansion, analysts predict that about 45,700 will enroll in the program over the next four years.
According to the AP/Bee, federal officials will review the program annually (AP/Sacramento Bee, 11/2).
HHS Secretary Sylvia Mathews Burwell said, "This agreement will bring much needed access to health care coverage to more than 70,000 low-income Montanans." She added, "The [Obama] administration looks forward to working with other states to expand Medicaid by designing programs that meet states' needs while providing needed services to residents and significant economic benefits to states" (Sullivan, The Hill, 11/2).
Meanwhile, some observers expressed concern over the amount of flexibility the administration could give to states for alternative Medicaid expansions. Families USA Founding Executive Director Ron Pollack said, "We don't want premiums to become part of the standard Medicaid expansions" (Wall Street Journal, 11/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.