Medicaid expansion sign-ups surging past expectations

KPAX, March 9, 2016

The number of low-income Montanans signing up for expanded Medicaid health coverage is surging past initial predictions, a legislative report shows.

The report says as of this month, 36,320 people have signed up for the new government-funded coverage – already more than the Bullock administration estimated would sign up through mid-2017.

Montanans earning up to 138% of the federal poverty level – about $16,400 a year, for a single person – are eligible for the expanded Medicaid coverage.

The federal government covers the cost of the expansion this year, but gradually scales back its share to 90% by 2020.

The 2015 Legislature approved the expansion and sign-ups began last November.

Rep. Art Wittich (R-Bozeman) — an opponent of Medicaid expansion — said Wednesday that no one should be surprised that “people will over-utilize free stuff.”

“In every state that expanded Obamacare Medicaid, the projections on enrollment and costs were exceeded by actual numbers,” he told MTN News.

But Heather O’Laughlin, co-director of the Montana Budget and Policy Center, a supporter of the expansion, said the brisk clip of sign-ups for coverage is something to celebrate.

“I think it shows there is a significant need for health-care coverage,” she said.

Covering more people who need health care will create economic benefits for the state, O’Laughlin said, such as preventing more serious mental illness, because people can get entry-level care, and reducing the amount of “uncompensated” health care.

The Bullock administration, which supported Medicaid expansion, predicted last year that 23,000 to 26,000 people would sign up through June of this year and that by June 2017, the sign-ups would reach 30,000 to 33,000 people.

Sen. Ed Buttrey (R-Great Falls) — who sponsored by bill that approved Medicaid expansion — said Wednesday he hadn’t yet examined the latest numbers. He said he’s meeting with Bullock administration officials on Friday to discuss the expansion’s progress.

The report by the Legislative Fiscal Division said the federal government spent about $21 million on the program during the first two months of the year. Coverage for people on the program began Jan. 1.

The report also said that only 11,600 of the people who’ve signed up for coverage are being administered by a contract managed by Blue Cross and Blue Shield of Montana. Blue Cross is acting as a “third party administrator” that arranges the provider network, processes the bills and manages the care.

The remainder – about 24,800 people – are covered by Medicaid that is administered directly by the state. This group includes people making less than 50 percent of the poverty level, Native Americans and the “medically frail.”

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