2015 Advocacy Packet

Medicaid Expansion: Key Messages for Health Care Advocates

  • A strong health care delivery system is essential to improving the health status of Montana. Reducing the number of uninsured Montanans will improve patient outcomes, drive down the overall cost of health care, and alleviate financial pressures hospitals experience due to uncompensated care.
  • The health care community is committed to improving access to quality, safe and affordable health care. Up to 70,000 Montanans could gain health insurance coverage if the state expanded Medicaid. (Includes 9,500 veterans; 20,000 American Indians; 43,000 working adults.)
  • Individuals enrolled in Medicaid are significantly more likely than the uninsured to access routine and preventive care and significantly less likely to avoid needed medical or dental care due to cost concerns. Providing Medicaid to low-income Montanans will increase utilization of primary care, disease management and mental health services.
  • Hospitals provide care to all Montanans, regardless of their health insurance coverage or ability to pay. As a result, uncompensated care is at an all-time high. Hospitals try to absorb as much of these unpaid costs as possible, but in order to maintain quality services a portion of this cost is shifted to private insurers.
    • 100% of physicians employed by hospitals and federally qualified health clinics and public facilities accept Medicaid. Additionally, all specialists holding exclusive contracts with hospitals accept Medicaid.
    • Montana hospitals absorbed nearly $400 million in unpaid charges in 2013. Of that amount, roughly $180 million was provided at no charge to low-income individuals.
  • Reducing uncompensated care ensures the viability of our rural safety-net hospitals. This helps ensure Montanans don’t have to drive hundreds of miles to receive quality health care. Nearly half of the 70,000 Montanans who would be eligible for coverage under Medicaid expansion live in a county with a critical access hospital.
  • Accepting federal funds to provide for meaningful expansion of coverage is the most cost-effective solution for Montana. By not expanding Medicaid, Montana has forfeited more than $566 million. We lose at least $1 million more every day. That’s money that should be responsibly spent on progress at home.
  • Regardless of your perception of the Affordable Care Act, expanding Medicaid is a common sense solution for Montana that will ensure the health and productivity of Montana’s workforce.
    • The federal government will pay 100% of the costs until 2017. After that, the state will pay no more than 10% of the cost. That’s a remarkable deal. The state currently pays about 34-35% for the beneficiaries in the traditional Medicaid program.
    • There is no evidence to support that claim that the federal government will change the amount of matching funds paid to states. States have the option to drop coverage for the expansion population at any time.
  • Expanding Medicaid is good business. A recent study suggests Montana will gain an estimated 12,000 jobs and $1.38 million in increased labor productivity. Those gains will generate slightly more than $143,000 in state and local tax revenue every day.

Medicaid Expansion: HB 455 Opposition

  • Montana hospitals are committed to improving the health of the communities they serve. Providing all low-income Montanans access to health insurance supports our goal of making Montana one of the healthiest states in the nation.
  • HB 455 locks too many Montanans out of affordable coverage. Providing health insurance to only 15,000 of the 70,000 eligible Montanans does not adequately improve population health or address the financial impact of the rising rate of uncompensated care.
  • Spending more state dollars to cover less people is bad business. Accepting enhanced federal dollars to increase coverage to all low-income Montanans is the most cost-effective solution for Montana.
  • Businesses are more productive when they have a healthy workforce. Enhancing our business climate by ensuring all Montanans have access to quality, safe and affordable health care will ensure Montana remains competitive in recruiting and maintaining trained and qualified professionals.
  • MHA supports two provisions included in the bill:
    • Improving management of prescription drug use
    • Increasing funding for people on the waiting list for home and community based services.
      MHA will urge the committee to include these funds in HB 2, the state budget bill.

Medicaid Expansion: Template for Letter to Legislator

[Insert Date]

[Address Lines]
[Address Lines]
[Address Lines]

Support Montanans by Opposing HB 455

Dear [Legislator]:

I urge your support of accepting available federal funds to expand Medicaid coverage to all Montanans earning up to 138 percent of the federal poverty level. Without full expansion, [insert number] of our uninsured neighbors in [insert county] will be left without health insurance.

Rep. Nancy Ballance (R-Hamilton) has introduced a measure that extends Medicaid coverage to only a select group of parents and veterans. I ask that you oppose HB 455, as it inadequately addresses the needs of the most vulnerable in our state. HB 455 will also cost the state more money than a plan that accepts the enhanced federal match to provide health insurance to all low-income adults.

That’s more money for less coverage, and Montanans deserve better.

Medicaid is a lifeline for individuals living in poverty. People with health insurance are significantly more likely than the uninsured to access routine and preventive care, and significantly less likely to delay medical treatment due to cost concerns. Increased utilization of appropriate services gives health care providers the opportunity to catch health problems early – which effectively improves patient outcomes, curbs wasteful spending and helps reduce the cost of health care for everyone.

Aside from the obvious health benefits, expanding Medicaid is good business.

Uncompensated care in Montana has increased 29% since 2010. At the same time, Medicare and Medicaid payments to our hospitals have been reduced by $400 million over 10 years. Expanding health insurance coverage will help alleviate these cuts, which could otherwise impact local salaries, benefits and the ability for my facility to recruit and maintain trained and qualified health care professionals.

The federal government will pay 100% of the cost of expansion until 2017. After that, Montana will pay no more than 10 cents for every dollar spent for Medicaid services. By not expanding Medicaid, Montana has
already forfeited more than $567 million in federal funding. That’s money that could have been used to improve the health of the most vulnerable in our state.

[Potential insert: It is my understanding that an out-of-state interest group, Americans for Prosperity, has been trying to influence the Medicaid debate in Montana. I am optimistic you are working with fellow legislators to shut down this unwelcome activity. Montanans know what is best for Montanans, and as a voter in [insert county], I appreciate you taking a stand against anyone trying to bully our elected leaders into supporting their agenda.]

Thank you for your attention to this critical issue. Many of Montana’s citizens are waiting for your swift and immediate action.

[Insert closing]

Medicaid Expansion: Bill Comparison

HB 455, sponsored by Rep. Nancy Balance (R-Hamilton), is scheduled for a hearing by the House Human Services Committee on Wednesday, February 18th. The bill is part of a 19-bill package supported by a group of legislative Republicans who aim to provide Medicaid to only a select group of low-income parents and veterans earning up to 100% of the federal poverty level. The bill applies for a federal waiver to cover the group of veterans. It does not provide coverage to able-bodied, childless adults.

HB 249, sponsored by Rep. Pat Noonan (D-Butte), will receive a hearing before the House Human Services Committee on Friday, March 6th. The bill includes Governor Bullock’s Healthy Montana Plan, which accepts enhanced federal funds to extend Medicaid to all low-income adults earning less than 138% of the federal poverty level. It includes coverage for able-bodied, childless adults.