Montana Gov. Steve Bullock signed legislation Wednesday to expand Medicaid eligibility to about 70,000 low-income residents. The CMS must approve the plan, which includes premiums equaling 2% of a beneficiary's income.
Montana would be the 29th state to expand Medicaid if the CMS grants its request for a waiver.
Under the proposal, participants would be offered assistance to find employment or a better-paying job.
There were many attempts to derail the Medicaid legislation along the way, including a campaign backed by the well-funded Americans for Prosperity, which has been credited with derailing expansion efforts in Kansas and Tennessee, and it continues to be an active force of opposition in Florida.
Republican state Sen. Edward Buttrey, who authored the law signed by Bullock, said he received political threats from the group.
Buttrey said he was able to get other Republicans in his state to back his proposal by positioning it as an economic engine. The bill, he told them, would help not only improve the health of Montanans, but it would also help them get out of poverty. He also said it would create jobs, mostly in the healthcare industry.
As with Medicaid plans adopted in other states with Republican-led legislatures, the Montana plan imposes cost-sharing on new beneficiaries. In addition to paying premiums for the coverage, they will have copayments for healthcare services.
Beneficiaries with incomes above 100% of the federal poverty level who do not pay premiums would have their debts sent to collections and, ultimately, their coverage would be terminated.
The lowest-income beneficiaries would not be kicked out of the program for failure to pay premiums. The CMS has made it clear in responses to other state proposals that it won't approve such provisions. The state will, however, make attempts to collect debts from those beneficiaries.
A CMS spokesman did not respond to a request for comment at deadline.
