Medicaid reports finds health, economic benefits for Montana
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More than one in every five Montanans, including approximately two in every five children, have health care coverage under the state’s Medicaid program. The program covers costs of physical, behavioral, emergency, vision, dental and long term care health services at low or no cost to those eligible. Those eligible are: children, pregnant and postpartum women and infants, people with disabilities, seniors, and adults with low income.
Without legislative action, Medicaid expansion, which expands Medicaid coverage to adults with incomes up to 133% percent of the federal poverty level, is set to sunset at the end of June 2025.
What Medicaid is, who’s covered, its statewide impact and more were outlined in a Dec. 12 webinar hosted by the Montana Healthcare Foundation.
The foundation is a private nonprofit that “makes strategic investments to improve health in Montana.” The organization conducts annual Medicaid in Montana reports “so that Montanans can reach informed decisions that contribute to a healthier state.” In 2024, the group released three different reports regarding Medicaid’s impact on the state’s budget, economy and health, it’s background, and what losing Medicaid expansion could mean for the state. Data from all three reports were used in the webinar presentation.
Montana Healthcare Foundation CEO Dr. Aaron Wernham explained that Medicaid plays a crucial role in the state’s healthcare infrastructure.
“There are some serious policy decisions that will need to be made in the next legislative session,” he said.
Manatt Health Senior Adviser Zoe Barnard also presented during the webinar. She described Medicaid as an agreement between the state and the federal government in which Montana is reimbursed 80% of its program spending.
She noted that the percentage of the state’s general fund that is spent on Medicaid has remained fairly constant over the past nine years – between $270 to $320 million that accounts for 13% of general fund spending.
The Montana Legislature expanded Medicaid to cover low-income adults in 2015 through the HELP Act. According to the foundation’s presentation, the state’s intention in doing so was to expand health care coverage, improve access to health services and outcomes, reduce costs of care and create state budget savings.
Of the 230,000 Montanans covered by Medicaid, 81,000 are adults in the expansion group. The report finds that 2/3 of Medicaid enrolled adults are employed or in school and that “Montana Medicaid has not decreased labor force participation.”
Medicaid expansion led to a 30% drop in the number of people in Montana without health insurance since 2015. Access to screenings and early diagnosis for low income adults corresponded to increased utilization of preventive services and decreases in emergency department visits among Medicaid enrollees the longer they had coverage.
When the entire family is covered, children have more access to health care. "Health care workers said again and again that if adults in the family were also covered, it was more likely that children in the family will receive care," Barnard said.
Additionally, expansion was found to: help Indian Health Service stretch its limited budget and improve access to non-emergency health services, increase access to behavioral health services, and provide an additional funding source for Montana’s behavioral health budget.
Barnard pointed out that public polling indicates 73% of Montanans support continued Medicaid expansion.
Dr. Bryce Ward, co-founder of ABMJ Consulting, led the portion of the presentation about Medicaid’s economic impact to the state.
Montana receives federal dollars every year, in excess of $900 million, for Medicaid reimbursement. Those dollars support jobs, income and economic growth. It was estimated that in 2022, incoming federal Medicaid money led to an addition of 7,500 jobs across industries, $475 million in personal income and $775 million in economic activity to the state’s economy.
“This is the cheapest jobs program available to the state of Montana,” Ward said. “Lots of jobs creation with very little amount of state spending.”
To access the reports referenced during the webinar, visit the Montana Healthcare Foundation’s website at: https://mthf.org/priority/medicaid-and-health-policy/. The foundation will release its 2025 Medicaid in Montana report along with an updated economic impact analysis in early January 2025.
