Medicaid expansion, infrastructure on the hot seat for 2nd half of legislative session
(UM Legislative News Service) Montana’s Legislature has passed the halfway mark in the 90-day biennial session and some of the most controversial debates, like Medicaid expansion and infrastructure funding, are yet to come.
The halfway mark also signifies a deadline for policy bills to be transmitted from one chamber to another. If transmission fails before the 46th day, the bills are dead. More than 240 bills have been killed either by missing the deadline or by lawmakers voting them down.
Gov. Steve Bullock has signed 56 bills into law so far. That includes House Bill 159, which implemented legally required inflationary adjustments to public school funding, and House Bill 20, which aims to streamline missing person reports.
Sen. Fred Thomas, R-Stevensville, said in a press conference he’s optimistic the Legislature will be able to close up shop before May 1. He said he’s pleased with the legislation that’s moved through the body.
“This is one of the more innovative sessions I think we’ve seen in a long time,” Thomas said.
In particular, Thomas pointed to two bills that passed the Senate.
Senate Bill 83 is carried by Sen. Steve Fitzpatrick, R-Great Falls, and would establish regulations for pharmacy benefit managers, or third-party contractors who help broker deals between pharmacies and health insurers. The bill would put a limit on how much they can charge for copayments, and would prohibit those copayments from costing more than the prescription itself.
Senate Bill 217 would cut state income taxes on social security benefits for individuals with adjusted gross incomes with a base amount of $30,000, and is sponsored by Sen. David Howard, R-Park City. Thomas said it would benefit Montana’s seniors. It would also decrease state revenues from taxes.
While some bills have passed by relatively large margins, others have ended on tight votes and sparked fiery debates among lawmakers.
Two legislators proposed constitutional amendments that proved particularly controversial. Rep. Derek Skees, R-Kalispell, introduced House Bill 269 which would have limited the number of taxes the state can implement to only two at a time. It split the Republican party and failed 38-62 to pass the House.
Rep. Greg DeVries, R-Jefferson City, is sponsoring House Bill 302. It would define personhood in Montana’s Constitution as beginning at conception. The House endorsed the legislation 56-43 and it will move forward to the Senate.
Because HB 302 is a constitutional amendment, it could bypass the governor’s desk, and his veto power, and be put to Montana voters. However, it will need 100 votes from the entire Legislature to get on the ballot, so the Senate would need 44 yes votes out of 50 members to move it forward.
As they start the second half of the session, lawmakers are now gearing up to tackle two of the biggest issues of this Legislature: Medicaid expansion and fixing and maintaining the state’s infrastructure.
Dueling Medicaid Expansion Bills
The debate over Medicaid expansion is scheduled for Saturday, March 16 with public hearings for dueling bills that would expand the subsidized health care program. If lawmakers can’t decide on a solution, the expansion of the program will expire in June.
Medicaid is a federal-state partnership that offers health insurance to low-income adults and families, and disabled individuals. Requirements are different in each state, but generally, Medicaid is only offered to those who are low-income and have a disability or condition that prevents them from working. The expansion program’s eligibility is based on income alone.
The federal government’s match rate for expansion is slowly decreasing — it was a 100 percent match rate in 2015-2016 and will be 90 percent in 2020 and beyond. This means the state will need to pay more into the program going forward.
Both Democrats and Republicans are proposing bills to renew the program. Medicaid expansion first passed in 2015 with bipartisan support. Nearly 100,000 Montanans are now enrolled in the program, which is greater than expected.
Rep. Mary Caferro, D-Helena, is carrying House Bill 425, which would end the program’s expiration date and add some fees for hospitals that benefit from Medicaid payments. The eligibility requirements and healthcare coverage would stay the same.
When expansion passed in 2015, the bill was carried by Republican Rep. Ed Buttrey from Great Falls. It revealed a rift in the Republican party and passed on a tight margin.
Buttrey is carrying the Republican-backed expansion bill again and although a draft of the bill has not yet been released, MTN News reported Buttrey’s bill will include work and “community engagement” requirements for recipients of Medicaid expansion. The requirements aim to regulate how many enrollees are eligible for the program, and removing those who are able-bodied but don’t work from the program.
Rep. Eric Moore, R-Miles City, said this bill has the best chance to pass between the two because it “reserves resources for those who need it most.”
Moore, who said he strongly opposed Medicaid expansion four years ago, said Montanans need consistency in government.
“I don’t think it’s good policy to put 100,000 people on a program and then take it away four years later,” Moore said.
Sen. Jon Sesso, D-Butte, said he felt the 2015 Medicaid expansion debate centered around getting enrollees to work, and that the current program has been successful on that front.
The 2015 legislation contained the HELP-Link program, which offers voluntary workforce development and is administered by the Montana Department of Labor and Industry. That department and the Montana Department of Revenue released a joint study in January that found 7 out of 10 Medicaid expansion recipients are working.
For this reason, Sesso said he is “bullish” in support for Caferro’s bill.
Democratic Gov. Steve Bullock has been pushing for a comprehensive infrastructure package to fund public works projects across the state since he took office, but has yet to see one pass. However, lawmakers seem to be making headway this session.
The most contentious part of the infrastructure debate between the parties is how the state will pay for the projects. The governor’s office says bonding, or borrowing money, is the way to go. Republicans have fought this method for years.
Moore said Republican hesitation comes from the uncertainty of bonding, and that the process to allocate infrastructure funding has been too arbitrary. The Miles City representative introduced a bill to address that problem.
House Bill 553 would implement a structure that provides clear guidelines for how the state pays for public works projects, while a different bill will include the actual funding. Moore’s bill passed the House 99-0 just before the halfway break.
Lawmakers like Moore and Sesso are hopeful HB 553 will help the actual bonding bill pass more easily. Moore said the funding legislation will likely be introduced before the end of the month, and that his bill will give the Legislature a clear target to hit.
Sen. Cary Smith, R-Billings, said he thinks his party understands there is a place for bonding in state funding, and that HB 553 will help keep debate on track.
“What we’re really trying to do is take the emotion out of it,” Smith said.
Emotions have run high in the past when lawmakers debate projects other than roads and bridges, like funding for renovations to MSU’s Romney Hall or the Historical Society’s museum. Generally, these projects get lumped together in one bill. This time, they’ll be split up.
Both Sesso and Thomas said the Historical Society will be included in a separate upcoming bill to address needed renovations at museums around the state. It has not been introduced yet.
As the Legislature continues to race to the finish line, the urgency to pass bills will intensify. For Sesso, the plan is simple.
“Let’s extend what we’re doing well.”
Shaylee Ragar is a reporter with the UM Legislative News Service, a partnership of the University of Montana School of Journalism, the Montana Newspaper Association, the Montana Broadcasters Association and the Greater Montana Foundation. Shaylee can be reached at email@example.com.