The issue of health care was in play again today in the Montana Legislature. On the day when three Republican health-care proposals were voted down on the floor of the Montana House, yet another proposal got its first hearing in the Senate Health Committee.
The bills killed by the House today were pitched as alternatives to Governor Steve Bullock’s Medicaid expansion plan. The most prominent of these was sponsored by Nancy Ballance of Hamilton, which would have used $30 million of state money, but no federal money, and provided coverage for an estimated 10,000 low-income Montanans. It died by a two vote 49 to 51.
Less than an hour after that plan went down to defeat in the House, another plan came up for its first scheduled hearing in the Senate. Republican Senator Ed Buttrey of Great Falls is proposing to take Federal Medicaid money to provide coverage for up to 70,000 low income Montana residents, as Governor Bullock’s plan proposed. But Buttrey’s plan includes some things intended to appeal to conservatives, most notably a jobs pan.
“This program will physically touch every member of the act, in an effort to perform an employment assessment and to enroll the member in a focused, job-driven effort to increase the money-making ability of the member. The act includes incentives for the member to take part in the program. The bottom line is that every effort will be undertaken to assist our poor with a true path out of poverty.”
Presenting Senate Bill 405 to the Senate Public Health Committee, he also explained how his plan would require all the participants, he calls them members, to pay a small premium for their coverage, unlike traditional Medicaid.
“By the way every user of the ACT plan pays their share. Nobody gets a free ride; there are no exceptions no matter what you hear. This is also a solution unique to Montana.”
Buttrey is also putting a tort reform element in his plan, intended to reduce the number of medical malpractice suits, which Republicans have long blamed as a cause of healthcare inflation.
The first witness in favor of the bill helped underscore the compromise nature of the proposal: Tara Veazey, Governor Steve Bullock’s Health care advisor, spoke in favor of the bill, but stopped short of giving it an unqualified endorsement.
“This is not the bill the governor would have drafted, and indeed there are policies in the HELP Act that concern him. But Montanans elected him and they elected you to work together across the aisle to find real solutions.”
Only a handful of witnesses lined up to speak against the bill. Most, like contactor Terry Bannan of Great Falls, were opposed on principal to the idea of taking any federal money for health care.
“All of the representatives from the different organizations weren’t talking about the fact that they were going to roll up their doors because they didn’t have the money. They see a $700 million dollar bait sticking out in front of them, and they want a piece of that action. I don’t know that it is going to have any real good effect on the outcome of the actual insurance, and or medical health care that we have here in Montana.”
Representatives of several Montana hospitals have testified in the past that uncompensated care is threatening their ability to survive, and Medicaid expansion would help address the problem.
Al Smith of the Montana Trial Lawyers Association argued against the tort reform steps in the bill, such as limiting the statute of limitations so that a medical malpractice suit could only be filed within two years of an injury, instead of three years, as the law now allows.
“In fact I’ve heard in prior sessions that Wyoming has a two-year statute of limitations. Well, Wyoming has a two-year statute of limitations, they have no tort reform and they have exactly the same health cre costs as us. There is no correlation.”
The Senate Health Committee listened to arguments for and against Buttrey’s bill for more than three hours, but deferred a vote on the bill, unlike the House Human Services Committee, which decided on the spot to kill Governor Bullock’s Medicaid expansion plan two week ago. The committee will probably decide whether to forward Buttrey’s bill to the Senate floor in the next week.