Montana Medicaid Expansion Faces Critical Decision as Sunset Date Approaches

Missoula, MT – Advocates gathered outside the Montana State Capitol on Wednesday to rally in support of the state’s Medicaid expansion program, urging lawmakers to extend it before the program’s scheduled expiration on June 30. The rally was organized by a coalition of healthcare and community organizations, including Catalyst Montana, the Montana Budget and Policy Center, the Montana Hospitals Association, and the American Cancer Society Cancer Action Network.

“We’re gathered here, of course, today, because the health care for nearly 80,000 Montanans is at risk,” said Alice Boyer, deputy director of Catalyst Montana. The group’s call for lawmakers to “Lift the sunset” echoed through the crowd, which included individuals from across the state advocating for continued Medicaid coverage.

Medicaid expansion, which has been in place since 2015, has provided health insurance to thousands of low-income individuals, particularly in rural areas and for tribal communities. Among the rally’s speakers was Joel Rosette, CEO of the Rocky Boy Health Center in Box Elder, who emphasized the benefits of Medicaid expansion for tribal members. “It’s worked,” Rosette said, citing improved healthcare outcomes and better resources for rural communities. “We’ve got better communities, we’ve got better resources for rural communities. We’re a healthier Montana than we were ten years ago.”

Rosette also pointed out that Medicaid expansion had reduced the uncompensated care his facility has to provide, allowing them to add essential services such as specialty care. He noted the impact on preventive health, highlighting that services like mammograms and colonoscopies are now available to individuals who previously had to wait years for such screenings.

In addition to healthcare providers, business owners also spoke in support of Medicaid expansion. Chelsia Rice, co-owner of the Montana Book Company, shared how the program has allowed her to offer health insurance to her full-time employees. She stressed that Medicaid expansion provides crucial healthcare coverage for part-time workers, particularly those who are caregivers or in other situations that limit their work hours.

“We cannot go back to a world where our workers and our community are left without health care coverage,” Rice said.

The business community’s support for Medicaid expansion was echoed by Todd O’Hair, president and CEO of the Montana Chamber of Commerce. O’Hair noted that many businesses in the state rely on Medicaid to ensure their employees, particularly part-time workers, have access to healthcare. “We see a lot of part-time people that have to take care of an elderly parent at home, have to stay at home to take care of their kids, are single – so working, want to work, want to contribute, but they need that access to Medicaid to be able to fill that gap,” he said.

O’Hair also emphasized that Medicaid expansion plays a significant role in supporting economic development in rural Montana. He warned that removing the program could add stress to communities already struggling to retain businesses and grow their economies.

As the Montana Legislature begins its 2025 session, Medicaid expansion is expected to be a major issue. Rep. Mary Caferro, D-Helena, announced plans to introduce a bill backed by the Democratic caucus that would extend Medicaid expansion and remove the community engagement provisions in the current law. The bill would also restore 12-month continuous eligibility for recipients.