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Governor, Rep. Noonan unveil proposal to expand Medicaid to more low-income residents

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HELENA, Montana — About 70,000 low-income Montanans would be covered under an expansion of Medicaid as long as the federal government covers at least 90 percent of the cost, the governor said Monday in his proposal on the issue.

Democratic Gov. Steve Bullock unveiled the legislation called the Healthy Montana Plan with sponsor Rep. Pat Noonan of Ramsay in a room of about 100 supporters at the Capitol.

Under House Bill 249, adults making up to $16,105 a year and a family of four earning up to $32,913 would qualify under the guidelines.

"These are Montanans who struggle to make ends meet," Bullock said, referencing cooks, ranch hands and day care providers. "Studies show that the vast majority of those without access wake up every single morning and go to work."

Bullock's proposal is based on the Healthy Montana Kids program, which provides coverage of children in low-income families. It would expand Medicaid in the same manner to adults through competitive state contracts with private insurance companies for care at negotiated rates.

Crystal Estelle of Havre is one of the thousands of people who would qualify for Medicaid under the bill. A single mother of two children whose job involves caring for disabled people, Estelle could be treated for rheumatoid arthritis and diabetes if the bill passed.

"I work just as hard as people working for a higher wage," said Estelle, who is also a college student. "I find it ridiculous that I do what I do and cannot get health coverage."

Republican lawmakers rejected the expansion in 2013 saying they feared the state eventually would have to pony up the costs.

A measure in Bullock's bill would terminate coverage if federal funding dropped below 90 percent. However, that doesn't make Republican Sen. Fred Thomas, chairman of the Public Health Welfare and Safety Committee, more willing to support the plan.

He said future legislatures easily could change that provision and once a government program starts, it's nearly impossible to repeal.

Earlier this month, Thomas and other Republicans unveiled their own proposal called the Montana Healthy Family Plan. It would expand Medicaid to as many as 15,000 people.

Thomas said he expects a bill with the major elements of that proposal to be introduced in the next week.

"I think what we're proposing is an excellent compromise and keeps Medicaid for society's most vulnerable and uses public dollars as efficiently as we can," Thomas said.

Thomas does like one section of the Bullock bill involving a mandatory fraud and abuse reporting system and said he thinks Republicans and Democrats will be able to work out a compromise.

Bullock said he's willing to work with lawmakers to find a solution but those who offer something significantly less than what the state could are not bringing a real plan.

"It's just essentially a deflection," Bullock said.

In response Thomas said, "We're here to drill down on the issues that need to be addressed, not just for spending more government money."

The District of Columbia and 27 states have expanded Medicaid.

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