Medicaid expansion fails Senate vote, but likely coming back

HELENA, Mont. (AP) — A bill to continue Montana’s Medicaid expansion program stalled Thursday on the Senate floor as Republicans sought to tie the fate of that measure — a top priority of Gov. Steve Bullock and Democratic lawmakers — to that of other legislation.

The Medicaid expansion bill failed on a 25-25 vote, and several Republican lawmakers said they were withholding their support until they see how other bills play out.

Medicaid expansion is “a huge bill for the Democrats, much more so than for us,” Senate President Scott Sales said Thursday. “There’s a few of us that think maybe we should get something for Medicaid expansion.”

Republicans are seeking support for a bill to allow NorthWestern Energy to purchase an additional share of a coal-fired power plant in Colstrip and additional capacity on a major power line.

Republican Sens. Tom Richmond and Duane Ankney voted against the Medicaid expansion bill Thursday, even though they’re listed as co-sponsors. They said they want support for their Colstrip bill, which is scheduled for consideration in a House committee on Friday.

“We work hard for a lot of our bills and we see absolutely no support on the other side of the aisle for a lot of our natural resource bills,” Ankney said shortly after the floor vote.

Democrats chided lawmakers for playing politics.

“The 96,000 Montanans who rely on Medicaid expansion don’t have votes to trade,” Bullock said in a statement. “The only choice they have is whether they get the health care they need or whether they can put food on the table for their families. Republican Senators should be ashamed.”

“I find it irresponsible — and frankly, dangerous — that some lawmakers would put politics over the health and wellbeing of so many of our friends and neighbors,” Senate Minority Leader Jon Sesso said in a statement.

Senate Majority Leader Fred Thomas said the Medicaid expansion bill will likely come up in the Senate again on Friday or Saturday. Lawmakers supported an amendment by Thomas to allow the health department to use state income tax information to verify income reported by Medicaid expansion applicants.

The Medicaid expansion bill has already passed the House, but would need to return to the House by next Tuesday for consideration of Senate amendments. There are 14 days left in the 2019 Legislative session.

Montana’s Medicaid expansion program began in 2016 and will end on June 30 unless lawmakers re-authorize it.

Republican Rep. Ed Buttrey, the bill’s sponsor, added work requirements, strengthened an asset test and asked Hutterite colonies to pay for the state’s share of the cost of coverage for their members to address Republican concerns that people were taking advantage of the program. The bill also includes a hospital tax.

The fiscal note estimates just over 88,000 of the people covered under Medicaid expansion are working, going to school or in other ways meeting an 80-hour-per-month community engagement requirement in the bill. Analysts estimate about half of the 8,100 who may not be meeting those requirements would be suspended from the program and possibly unenrolled if they fail to take advantage of work training opportunities.