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Thursday, April 23, 2015

Montana Victory Offers Latest Sign of Hope for Medicaid Expansion in 2015

Patrick Willard

Senior Director of State and National Strategic Partnerships

After the 2014 elections, the predictions for Medicaid expansion were full of doom and gloom. But as lawmakers begin to close out their sessions in 2015, there are signs of progress and hope that opposition to Medicaid expansion is eroding. Montana offers the most recent case for optimism, as it is now the 30th state (including D.C.) to expand Medicaid under the Affordable Care Act.

The 2015 legislative session opened with GOP lawmakers controlling more seats than at any time in the past 95 years. There were 31 Republican governors in office, including 18 of the 22 states that had not expanded Medicaid coverage. Despite the pessimism, from Florida to Alaska lawmakers seriously weighed plans for coverage reform in 2015. 

Bipartisan support for expansion in Montana

The victory in Montana showed that a bipartisan effort can win in legislatures when the lawmakers are allowed to bring a proposal to the floor. The Montana Health and Economic Livelihood Partnership Act passed because it was not stopped in a conservative committee by legislative leaders as happened with Governor Bill Haslam’s Insure Tennessee plan. Montana’s legislature allows a “silver bullet” for the minority party to blast a bill out of committee to the floor with a simple majority vote. A bipartisan majority was able to overcome the opposition of legislative leaders and win.

The Montana proposal also benefited from a strong grassroots advocacy push. In 2013, Medicaid expansion fell just short in the legislature after a robust debate. A referendum drive kept the issue alive through 2014, giving advocates a base of supporters who could call on lawmakers during the 2015 session. The grassroots advocacy was able to offset the spending and lobbying of opponents like Americans for Prosperity with more than 10,000 calls to the Capitol switchboard.

More governors leading the campaign to expand health coverage 

The good news of 2015 is that more governors are working to expand and reform coverage. Utah Gov. Gary Herbert will be continuing to work on the Healthy Utah Plan in a special session this summer. Herbert joins Haslam, Wyoming Governor Matt Mead, Alaska Governor Bill Walker and Idaho Governor Butch Otter in crafting alternative coverage proposals for expansion.

More good news can be found in the reports of the success of Medicaid expansion in state budget savings, reductions in the uninsured, and more health care jobs in those states that expanded coverage. Those reports will be used to buttress the arguments for expansion when lawmakers reconvene in 2016.