A Republican bill touted as an alternative to the governor's plan to expand Medicaid to 70,000 low-income Montanans would create a state fund to cover "catastrophic" healthcare costs for some adults who do not have children.
Rep. Art Wittich presented House Bill 582 in the House Human Services Committee Friday. The panel took no immediate action on the bill.
"The real importance of this bill is ... it deals with if you get into a car accident, if you have a major medical event, cancer, disease, whatever. Providers, that includes hospitals and private providers and doctors, can submit claims to this fund."
The Bozeman lawmaker's Catastrophic Health Care Costs Act would create a $35 million account funded by the state. It would cover certain healthcare costs for about 1,600 adults over two years who incur services exceeding $10,000. Money for the fund would come from an existing health insurance tax that currently goes to the state.
To qualify, an adult would have to make less than about $11,000 per year and fit other criteria such as not having a car worth more than $7,500.
The bill also requires a Medicaid gap analysis to determine where to focus resources throughout the state. It also requires a cost study to determine "what the real healthcare costs are" because Wittich said he believes hospital administrators who have talked about uncompensated care are doing quite well financially. No hospital representatives attended the hearing.
State Medicaid Director Mary Dalton said she opposes what she called a complicated bill because, among other things, it saddles people with $10,000 in medical debt before assistance kicks in.
"I think that there are other vehicles that offer more coverage to more people and don't spend $35 million in state funds to do that," she said.
As written, the bill would cover people diagnosed with cancer and patients admitted to hospitals while leaving out services such as bone marrow transplants, which riled up several of the eight opponents. Wittich said he could amend the bill to include all services covered by Medicaid.
The only supporter of the bill came from Kieley Keane with the Montana Medical Association who said they support any bill that expands healthcare coverage.
Republicans are also pushing a bill that would expand Medicaid coverage to about 10,000 veterans, low-income parents and some people with disabilities and would cost the state more than $20 million annually. Wittich said a third bill in their plan involves spending money to educate and encourage low-income people to sign up for health insurance on the federal exchange.
Gov. Steve Bullock said Friday these proposals are not alternatives.
"I'm not going to embrace something that costs more and doesn't cover working Montanans," he said.
Bullock's proposal to accept federal money to cover thousands of low-income residents and pay up to 10% of the cost after the first few years, House Bill 249, was shot down by Republicans earlier this week.
The full expansion has support from some Republicans. Sen. Ed Buttrey, R-Great Falls, is currently working on a similar bill that would also accept federal money to expand Medicaid. The bill has not yet been introduced.
