Medicaid Expansion Waivers: Providing Options, Protecting Montanans

Montana has the opportunity to extend health care coverage to 70,000 low- and moderate-income adults across the state, injecting billions of federal dollars into the state economy. While providing direct access to Medicaid by expanding eligibility tends to be more cost-effective, policymakers in some states used alternative ways to insure low-income citizens and access federal investment. Because of flexibility in the federal health care law, Montana has the ability to craft a plan to expand health care coverage in a way that works for our state. One of these options, implemented in other states, is the use of a Section 1115 waiver from the federal government.

It would also be a boon to Montana’s economy. Expanding coverage would create 12,000 good-paying jobs in health care and related fields and bring in over $5 billion in federal funds by 2021, boosting local economies across the state.

Medicaid expansion has been a success in the 26 states (and the District of Columbia) that embraced it, including the four that have done so through a Section 1115 waiver. The number of people without insurance in those states has dropped dramatically, from 16 percent to 10 percent. In Arkansas, nearly 200,000 more people have health care coverage, and over 400,000 in Michigan. States that expanded Medicaid also experienced a significant reduction in unpaid hospital bills and other costs incurred for treating people without health insurance.

Knowing exactly what a Section 1115 waiver is and learning from the success of other states will give our state the information it needs to make smart decisions that work for Montana.

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