Montana’s lawmakers respond to Washington’s health care plan

HELENA - According to a report released by the Congressional Budget Office last week, some states that expanded Medicaid as a part of the Affordable Care Act could end their programs under the Republican plan to repeal and replace the landmark health care legislation.

That's because of a step-down in how much the federal government reimburses the state. Numbers from the state Department of Public Health and Human Services applied to the Congressional Budget Office predictions of the bill's impact show Montana would have to come up with $251 million a year to make up lost federal dollars.

For perspective, it takes roughly $93 million a year to operate the entire Department of Justice.

No one will say if that spells the end of Montana’s program, which covers 71,000 people. Gov. Steve Bullock, a Democrat, says it's irresponsible to the state's economy and to the people who gained coverage under expansion to hypothesize.

"To move quickly on a proposal that is really half-baked isn’t in the best interest for Montanans, nor is it in the best interest for the country,” he said.

But House Minority Leader Jenny Eck, D-Helena, said it's too big a tab for the state to pick up. “I don’t know how we could possibly compensate for that loss," she said.

U.S. Sen. Steve Daines, a Republican, criticized his party's plan last week after the federal report said 14 million people would lose coverage next year. In a statement to the Associated Press, Daines said, "We need to do better. I want to see costs and premiums go down to make health care more affordable."

Rural hospitals are critical to the survival of small communities, said Montana's other U.S. senator, Jon Tester, a Democrat from Big Sandy.

“Pick my hometown or any other small town. You take that hospital out and that town’s going to be gone. It’s a simple fact people have to live close to their health care, and the older they get the closer they have to get. If that hospital is gone, they’ll have to move to Great Falls or Havre."

Republicans argue that those who are currently covered under Medicaid expansion will be able to keep their coverage. "The current plan will not pull the rug out from anyone," a spokesperson for Daines said Friday.

While that's true, critics of the plan say many churn through the Medicaid, gaining and losing coverage through their year as their financial situations change. The Republican plan will reimburse states at a lower rate for those who drop off and come back on after 2020.