Ballot Initiative Would Re-authorize Montana Medicaid Expansion

Feb 22, 2018

Two healthcare groups plan to ask Montana voters to continue the state’s Medicaid expansion in November, and to fund it with a higher tax on tobacco .

The Montana Hospital Association and the American Heart Association filed ballot language today.

Montana’s Medicaid expansion, passed by the 2015 Legislature, has extended health care coverage to more than 90,000 state residents who were previously not eligible for Medicaid. Now, nearly anyone in Montana who makes less than about $17,000 a year is eligible for Medicaid.


That will sunset, or expire, next year unless expansion is re-authorized by the state Legislature in 2019. The bill’s sponsor, Great Falls Republican Senator Ed Buttrey has told Montana Public Radio that he would not vote to re-authorize the current Medicaid expansion, known as the HELP Act.

"I would not vote today to simply remove the sunset on the HELP Act," Buttrey said.

The ballot language filed with Montana’s Secretary of State today proposes raising the state tax on cigarettes by two dollars per pack, and by 33 percent of the wholesale price for all other tobacco products, including e-cigarettes.

In 2016, the first year of Medicaid expansion in Montana, the federal government paid 100 percent of the program costs. That amount ramps down to where Montana is eventually responsible for 10 percent of the program’s costs. State lawmakers estimate that will be about $150 million in 2019 and $200 million in 2020.

Signatures for the ballot measure are due by June  22. The petition must be signed by at least five percent of the qualified electors in the state at large, including at least five percent in each of at least one-third of the legislative representative districts.