Medicaid expansion in Montana took another step forward Tuesday with the start of a public comment period on the plan, which is required before it goes to the federal government for review.
Gov. Steve Bullock is encouraging Montanans in the next two months to read and comment online on the proposal. Public meetings will be held to accept comments in Billings on Aug. 18 and in Helena on Aug. 20.
Because the plan includes non-traditional Medicaid elements such as monthly health care premiums for enrollees, the state must submit a waiver and gain federal approval before the expansion can be implemented.
"This draft waiver is an important step toward allowing Montanans to access coverage," Gov. Steve Bullock said in a statement.
Sponsored by Ed Buttrey (R-Great Falls), the Montana Health and Economic Livelihood Partnership (HELP) Act, passed through the Legislature and was signed by Bullock this spring. Buttrey's plan was touted as a compromise after Bullock's plan failed to gain traction.
The new law would accept federal funds to expand Medicaid eligibility to approximately Montanans with incomes at or below 138% of the federal poverty level, about $16,000 per year for an individual and $33,000 for a family of four. State officials said previously about 70,000 people would eligible but raised that estimate to 80,000 this week.
The new law would require people who enroll to pay health care premiums that amount to 2% of their income as well as copays.
In May, the Obama administration cited concerns about Montana's plan, but said it is willing to work with the state on solutions that are consistent with federal law. Agency spokesman Ben Wakana at the time said their priority will be to make sure that any waiver approval provides for coverage that is affordable and accessible for Montanans.
State officials said this week they plan to push to have Medicaid expansion up and running by Nov. 1 to coincide with the regular Affordable Care Act open enrollment period.
HHS staff will submit the waiver to the CMS for approval once the comment period is complete. It won't be new to federal officials as Buttrey and state officials have been talking with them for months.
Once they receive the waiver, federal officials will post their own 30-day comment period and after that have no specific deadline for plan approval.
"This is the beginning of a long process, but as we prepare to submit this draft waiver to the federal government, I'm confident they will quickly recognize that the health and wellbeing of tens of thousands of Montanans are counting on us to get this right," Bullock said.
As originally enacted, the Affordable Care Act required states to expand Medicaid to adults earning up to 138% of the federal poverty level. A U.S. Supreme Court decision in 2012 made the expansion optional for states.
Medicaid expansion plan comments can be mailed to Jo Thompson, PO Box 202951, Helena, MT 59620-2951, or submitted electronically to Online: http://dphhs.mt.gov/medicaidexpansion