Affordable Care Act

Five Challenges Facing Medicaid At 50

Jul 31, 2015
President Lyndon B. Johnson signed the bill creating Medicare and Medicaid at the library of former President Harry Truman, who was in attendance, on July 30, 1965.
Courtesy of Truman Library

A “sleeper” provision when Congress created Medicare in 1965 to cover health care for seniors, Medicaid now provides coverage to nearly one in four Americans, at an annual cost of more than $500 billion. Today, it is the workhorse of the U.S. health system, covering nearly half of all births, one-third of children and two-thirds of people in nursing homes.

U.S. Supreme Court
Flickr user: Marty Stone (CC-BY-NC-2)

The Supreme Court’s decision to uphold the Affordable Care Act’s subsidies for people to buy health insurance means nothing really changes in Montana’s health insurance market. And that’s pretty big news.

Senator Daines' office

In a speech on the Senate floor last week, Montana Senator Steve Daines lambasted President Obama for what he says are huge increases in the price of health insurance in Montana, but he didn't get the facts exactly right.

Montana’s insurance commissioner says she’s not surprised that health insurance companies are asking for rate increases next year of more than 20 to 30 percent. But, she says, those are just requests, and it’ll be at least a couple of months before the actual rates are known.

Steve Jess, MTPR


Yesterday Governor Steve Bullock, a Democrat, signed a Medicaid expansion bill into law that was sponsored by a Republican senator, Ed Buttrey. Buttrey has long been opposed to Medicaid expansion as called for in President Obama’s Affordable Care Act. So how did the businessman from Great Falls come to sponsor a Medicaid expansion bill? I asked him about that immediately after yesterday’s bill signing ceremony at the capitol.

Gov. Bullock signs the Medicaid expansion plan into law on April 29 at the captiol. The bill's sponsor Sen. Ed Buttrey, and supporter Stephanie Wallace look on.
Steve Jess

Backers of Medicaid expansion celebrated in Helena today as Governor Bullock signed the bill extending the health coverage to an estimated 45,000 more Montanans.

Legislative Roundup: Medicaid Expansion, State Budget Advance

Apr 12, 2015
From left, House Speaker Austin Knudsen, R-Culbertson, Rep. Jeff Essmann, R-Billings, and Minority Leader Chuck Hunter, D-Helena, debate rules on the House floor April 8.
Michael Wright - UM Community News Service

After wrangling over rules, the last remaining bill to expand Medicaid at the 64th Montana Legislature appears to be headed to the governor’s desk.

William Marcus

A bill to extend Medicaid to Montana's working poor won preliminary approval in the Montana House on a 54 to 46 vote. But before it could, supporters of Senate Bill 405 had to fight off another attempt to kill this bill again in committee.

The last surviving bill on Medicaid expansion has been the subject of numerous procedural fights with the most intense action over whether it could come to the House Floor for debate. That finally happened Thursday.

Medicaid Expansion Bill Survives Another Day

Apr 8, 2015

Democrats won their fight to bring a Medicaid expansion bill to the House floor for debate.  It came with help from 11 Republicans Representatives.

Sen. Ed Buttrey (R) SD13
Montana Legislature

Tuesday brings a crucial test for Medicaid expansion in Montana. Republican Senator Ed Buttrey’s bill to offer the government-funded health coverage to about 70,000 more Montanans faces a hearing before the same committee that killed a similar proposal by Democratic Governor Steve Bullock.

Health insurance plans in Montana would have to offer some policies that didn’t cover abortion services, under a bill heard today in a House Committee.

The bill would guarantee that customers who didn’t want their premiums going to pay for abortions could choose a policy from any provider on the insurance exchange that was abortion-free, except for cases of rape, incest, or a threat to the mother’s life, cases where the law requires all policies to cover abortion. That drew objections from several advocacy groups.

Medicaid Expansion Compromise Clears Montana Senate

Mar 30, 2015
William Marcus

Senator Ed Buttrey says he's pleased his bill to extend Medicaid coverage to the state's working poor won final approval in the Senate.

Eric Whitney

The Montana Senate today gave preliminary approval to a bill to expand Medicaid coverage to the state's working poor on a 28 to 22 vote.

For Senator Buttrey, Medicaid Expansion Is A Riddle And A Risk

Mar 25, 2015
Sen. Ed Buttrey (R) SD13
Montana Legislature

Middle ground on Medicaid expansion eluded the Montana Legislature in 2013, and since then Senator Ed Buttrey, R-Great Falls, has studied the issue, talked to hospitals and members of the other party and others to get to where he was last week: standing in front of the Senate Public Health, Welfare and Safety Committee.

The lone surviving bill seeking to expand Medicaid coverage to the working poor will have another hearing tomorrow at the Montana Legislature.

This action comes on the heels of the bill stalling last night in the Senate Public Health Committee.

Another Medicaid Expansion Plan Introduced At The Montana Legislature

Mar 17, 2015
Sen. Ed Buttrey (R) SD13
Montana Legislature

The latest proposal to expand health insurance coverage for the working poor is scheduled for a legislative hearing Friday.

Chuck Johnson, Sally Mauk and Mike Dennison
Eliza Wiley

This week on "Capitol Talk", Sally, Mike and Chuck cover pre-school education's tough reception at the legislature, the infrastructure funding debate, Medicaid expansion passions, and concealed carry on campus.

"Capitol Talk," our weekly legislative news and analysis program, appears on Fridays throughout the legislative session. MTPR's Sally Mauk is joined by Lee Newspapers reporters Chuck Johnson and Mike Dennison.

Tune in to "Capitol Talk" on your radio every Friday during the session at 6:35 p.m. and again on Sunday at 11:00 a.m.

'Catastrophic Health Care Costs' Bill On Friday's Legislative Agenda

Mar 12, 2015
Montana Capitol
William Marcus

Expanding healthcare is on the agenda yet again at the Montana Legislature Friday.

Republican Representative Art Wittich of Bozeman is carrying House Bill 582, and says it’s a part of the Republicans' alternative plans to the governor’s Medicaid expansion.

Insure Montana Program Seeks State Funds To Continue Operation

Mar 10, 2015
William Marcus

A made-in Montana health insurance program aimed at helping small businesses cover their employees is seeking money from the general fund to continue operation.

Some members of the Senate Finance Committee question the expenditure since these workers could also get insurance under the federal Affordable Care Act (ACA).

Insure Montana was created before the ACA became law. The intent was to help small businesses in Montana, initially those with nine or fewer employees, provide health insurance for their workers.

House Blocks Attempts To Revive Bullock's Medicaid Expansion Bill

Mar 10, 2015
Michael Wright - Community News Service

The Republican-controlled House officially killed the governor's Medicaid expansion proposal. That's because House Democrats failed to convince the Republican controlled chamber to reject the "do not pass" recommendation from the House Human Services Committee on the bill. That action came Friday night immediately after a nearly six-and-a-half hour-long hearing.

Eric Whitney

Governor Bullock's bill to expand Medicaid gets its first hearing in the state legislature on Friday. Watching closely will be Montana's hospitals.

To understand why, drop by an emergency room at one of Montana's bigger hospitals, like Benefis in Great Falls.

This ER serves about a quarter of the state's population. And 10 to 12 percent of Benefis' patients can't afford to pay their bills. Last year, that added up to $36 million in unpaid bills, or about three times the hospital's profit margin.

Kaiser Family Foundation

Montana is doing a better job than most states at getting people signed up for health insurance under the Affordable Care Act.

A new analysis from the Kaiser Family Foundation shows that 45 percent of Montanans who are eligible to buy insurance had done so, as of February 15. Those eligible to buy insurance are generally anyone who doesn’t already have coverage through their job, a spouse or a government program like Medicare or Medicaid.

The deadline to buy health insurance at was Sunday, and a lot more people in Montana did that this year than did last year.

“It’s encouraging to us that more than 54,000 Montanans went to to purchase their health insurance,” said Jesse Laslovich, chief legal counsel for Montana’s insurance commissioner.

That’s compared to about 37,000 last year.

Montana Republicans Unveil Healthcare Plan, Minus Medicaid Expansion

Feb 10, 2015

A conservative group of Republican lawmakers unveiled their plans to address healthcare in Montana that don’t involve Medicaid expansion. It’ s dubbed “Big Sky Health.” The package contains just over 20 bills.

This is the last week for Montanans to shop for health insurance on The deadline is Sunday, February 15. And it’s a hard deadline, says Jeff Hinson, with the U.S. Department of Health and Human Services.

"They will not be able to enroll after the 15th, unless they have a life-changing event."

A life-changing event is something like leaving a job with insurance benefits, getting married or divorced, or having child.

Bullock Touts Medicaid Expansion At Choteau Hospital VIsit

Feb 6, 2015
Teton Medical Center

Just over 40 percent of the patients who get care at Teton Medical Center  in Choteau are uninsured and can’t pay their medical bills. That’s the message the hospital’s CEO gave to Governor Steve Bullock Thursday afternoon.

Teton Medical Center is one of the state’s Critical Access Hospitals. It has ten hospital beds, just over three dozen nursing home beds, and an emergency room.

There are about three percent fewer Montanans without health insurance thanks to the Affordable Care Act. That’s according to University of Montana Economist Bryce Ward. He says the ACA is responsible for even bigger drops in the number of uninsured in other states.

"If the ACA stays around, we expect to continue to see the share of people without health insurance declining over the next few years."

Medicaid's Western Push Hits Montana

Jan 6, 2015

The Affordable Care Act is on the move in Western states, with the governors of Utah, Wyoming and Montana all working on deals with the Obama administration to expand Medicaid in ways tailored to each state.

But getting the federal stamp of approval is just the first hurdle. The governors also have to sell the change to their state legislators, who have their own ideas of how expansion should go.

The latest example is Montana, where the governor and the legislature have competing proposals about how much federal Medicaid expansion cash the state should try to bring in.

Montana CSI

Jennifer McKee from the office of the Montana Commissioner for Securities and Insurance talks with MTPR News Director Eric Whitney about the first tally of Montanans using to enroll in the Affordable Care Act.


2011 Century Council

Montana Governor Steve Bullock discusses Medicaid expansion, early-childhood education, infrastructure spending, the upcoming legislature, and more with "Home Ground" host Brian Kahn.

Here are some highlights from the interview:

Medicaid Expansion

Gov. Bullock says the "Healthy Montana" plan is a unique solution that will insure thousands of Montanans and help relieve the burden of uncompensated care on small hospitals.