Time to get real about Medicaid expansion

For the last three months, legislators have heard from countless Montanans who are terrified that they and their families will lose their health care in June. They told us that Medicaid expansion allows them to afford their life-saving medication, or get the preventative care to find a tumor early enough to seek successful treatment. They are workers, full-time caregivers, veterans, students, seasonal employees, and parents.

And for those Montanans, with each passing day that the Montana Legislature does not reauthorize Medicaid expansion, their lives come closer and closer to being thrown into uncertainty.

That’s why Democrats introduced a bill in the first week of the legislative session to reauthorize Medicaid expansion, the Keep Montana Healthy Act. Yet the Montana Legislature is dragging its feet on getting this legislation passed. And the reasons why tend to be based more in fiction than in fact.

Some lawmakers have been saying that Medicaid expansion enrollees don’t have “skin in the game.” That couldn’t be more inaccurate.

Medicaid expansion enrollees are working. Seven in 10 enrollees work themselves, and eight in 10 come from working Montana families. But there is no question that the remaining two in 10 enrollees are putting in their hours. Some are caregivers, who don’t collect a paycheck for their important work. Some are Montana students going to school to secure a better economic future. Montanans value hard work, and Medicaid enrollees are no exception.

A handful of our colleagues claim that Medicaid expansion creates a culture of “dependency.” Those lawmakers ignore the successes of HELP-Link, Montana Medicaid’s workforce training program that connects Medicaid enrollees with job training opportunities, resources to attend school, and the tools to earn higher wages and lift themselves out of poverty. The program has served 29,000 Medicaid expansion enrollees since its launch in 2015 — and has been so successful that other states are looking to model their own programs after Montana’s.

Let’s invest more in a tried and true program that actually puts people to work, not a bureaucratic system that punishes people.

Possibly the most misleading claim of all is that Medicaid expansion is too expensive. In fact, the opposite is true: Medicaid expansion has saved our state tens of millions of dollars, generated hundreds of millions of dollars in economic growth, and has even created 5,000 jobs.

Given Medicaid expansion’s undeniable financial benefit to our state, we find it extraordinary that Senate President Scott Sales would send $8 million of Montana taxpayer dollars to D.C. bureaucrats to build a section of wall, but does not believe Medicaid expansion is a responsible and worthwhile investment.

What’s worse? The Republican proposal to gut Medicaid could cost more taxpayer dollars in bureaucracy alone.

The state of Kentucky has had to budget $187 million a year to pay for the administrative fees associated with their work requirements—in Alabama, $79 million. Spending more money to provide benefits to fewer people is fiscally reckless.

Republican lawmakers must reckon with these facts, and more, if they intend to gut Montana Medicaid expansion as we know it.

Our constituents sent us to Helena to roll up our sleeves and get the job done, not do harm. At the end of this legislative session, each legislator should be able to walk out of the Capitol and know they didn’t take life-saving care away from their working constituents.

Montana is watching. We hope that our colleagues join us in doing the right thing.

House Democratic Whip Rep. Kim Abbott, Helena; and House Democratic Caucus Chair Rep. Laurie Bishop, Livingston.