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Time for action on Medicaid expansion


In 2015, Democrats and Republicans in the Montana Legislature put aside their partisan and ideological differences, taking advantage of the federal Affordable Care Act and expanding Medicaid coverage to more than 90,000 low-income Montanans, nearly 10% of the entire population of the state. That was a decision that would benefit Montana deeply and proudly.

It meant that 90,000 of our neighbors would now receive the regular and preventative health care that most Montanans enjoy, instead of having to wait to get sick and wait in a hospital emergency room when they need care. It also meant that parents didn’t have to worry about going bankrupt when taking their children to the doctor. It meant that healthcare providers, rural hospitals and Indian Health Service clinics, which were struggling to keep their doors open as costs rose and revenues lagged, got much-needed relief.

And with the federal government picking up more than 90% of the cost of Medicaid expansion, it was a great deal for Montana taxpayers: Some of our dollars we sent to Washington came back home and did good work.

But now Medicaid expansion is threatened by neglect, incompetence and political hostility.

During the pandemic, Congress allowed people enrolled in Medicaid to remain enrolled without having to prove they still qualified for coverage. When the crisis was over, that ended. Nationwide, more than 20 million people lost coverage until they could prove they could still qualify.

The loss of coverage didn’t have to be that bad: States were expected to re-enroll those who were still eligible within 45 days, and most states did indeed do a lot better than that. Nationally, more than two-thirds of re-registration applications were processed within a week.

But not by Governor Greg Gianforte’s administration in Montana. Last year, more than 130,000 Montanans were dismissed from Medicaid. It has taken a nightmarish amount of time to get them re-enrolled, and many applications have been rejected or still not processed.

Nearly 40% of reenlistment applications have taken more than 45 days to process, making Montana one of the worst states in the country where people are being abandoned, unable to pay medical bills for themselves and their children, or unable to attend go to the doctor when it is really necessary. Meanwhile, hospitals are laying off employees and freezing the number of employees they need.

No one would be surprised to learn that the Gianforte administration is deliberately trying to undo the Medicaid expansion: After all, it is up for reauthorization in the 2025 legislative session, and extremist Republicans have already said they will try to thwart it. They can always hope to get a hand from Ryan Zinke in that effort.

Where is Zinke in all of this? He has not spoken out on behalf of thousands of Montanans who have lost health care, but has joined Gianforte in other extremist positions. Zinke has been part of the most unproductive Congress in history, spending time on chaos and petty infighting instead of voting to get the country’s business done.

A party loyalist and member of the Republican Study Committee, Zinke has allied with extremists in his party who would raise the retirement age for Social Security and Medicare, stop allowing Medicare to negotiate drug prices, and raise both the Medicare cap Would repeal $35 on US health care as a member of the Republican Study Committee. price of insulin and a $2,000 limit on Part D out-of-pocket costs.

In other words, when it comes to federal programs that are essential to the well-being of seniors in Montana, Zinke joins those who want to dismantle and abolish these programs.

I guarantee you I won’t. Rather, in Congress I will work to defend and improve the programs that provide all Montanans and all Americans with access to affordable, high-quality health care and seniors with the retirement income they paid for and was promised.

Monica Tranel is the Democratic candidate for the U.S. House seat in Montana’s Western District. She lives in Missoula.

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