Hope for middle ground on Medicaid expansion

Montana Gov. Steve Bullock released his ambitious $10.3 billion state budget on Thursday that calls for an extension of the state’s Medicaid expansion program. Not surprisingly, the two-year budget proposal was immediately met with push back from Republican leaders.

Bullock’s budget calls for spending $30 million on preschool education, putting a freeze on university system tuition, investing nearly $300 million in infrastructure, as well as extending the Medicaid expansion made available through the Affordable Care Act. He hopes to help fund all this and more with a series of tax hikes that are, in part, aimed at the tourism industry and vices (booze and tobacco products, hotel rooms and rental cars). About $300 million would be left in reserves.

The Democratic governor has a tall order in attempting to persuade the GOP-controlled House and Senate to bend his way.

Republican leadership was quick to denounce Bullock’s plan as too heavy on spending, and beyond the state’s means, stating simply “it’s not going to happen.”

The ensuing battle over whether to extend the Medicaid expansion program — which is set to expire in June — will likely take center stage once the Legislature convenes in January.

Republicans are already pointing to failed ballot initiative 185 as the litmus test of public support. The initiative aimed to raise taxes on tobacco products to help fund the health-care program that currently insures nearly 100,000 low-income Montanans. About 53 percent of the people who voted rejected the ballot proposal.

Bullock, however, takes a different view. He told the Associated Press that he doesn’t look at I-185’s failure as a rejection of Medicaid expansion, and said he doesn’t believe anybody wants to reverse the gains made with the program’s passage in 2015.

Now, like in 2015, compromise legislation with bipartisan support will be absolutely necessary if this program is to continue on. Let’s not forget, one in 10 Montanans are insured through the Medicaid expansion. If it’s allowed to sunset, then what?

A bright spot from Thursday’s tit for tat between Bullock and the GOP is that there does appear to be a willingness to listen and to work toward a common goal.

Republican leaders have said that in order to gain their support for any new Medicaid expansion program, it would need to include work requirements, tests for eligibility and possibly drug testing. Bullock, for his part, said he was willing to work with Republicans on those potential changes.

We’ll see how it shakes out, but at least there’s a sliver of hope for middle ground.