Opinion: I voted for Medicaid expansion, but can't support I-185

When I voted for the Montana Health and Economic Livelihood Partnership (HELP) Act, also known as Medicaid Expansion, in 2015, I did so for two reasons.  First, to ensure that vulnerable Montanans had access to affordable health coverage. Second, to ensure that we were giving those same people the skills they need to get higher-paying jobs so they would no longer need to rely on government assistance.

I continue to support Medicaid Expansion, but I do not support Ballot Initiative 185 (I-185). I ask that you join me this November, and vote NO on I-185.

One of the most important provisions of the HELP Act was a “sunset” clause, which required that the Legislature reauthorize the entire program in 2019.  We intentionally put this provision in the bill to ensure that we could evaluate costs and make needed adjustments to the program.

I-185 eliminates the sunset provision, permanently locking in the current Medicaid Expansion law and stripping away the Legislature’s plans to address costs, evaluate effectiveness and discontinue parts of the legislation that don’t work.

I am committed to ensuring that Medicaid Expansion continues in Montana, but it should not continue in its current form. We have an obligation to ensure tax dollars are used efficiently and that Montanans receive the highest quality services possible.

In the 2015 legislation, we included a program intended to provide job training for Medicaid Expansion recipients that could work but did not have a job or were under-employed. Only 22% of Medicaid Expansion enrollees have signed up for the training.

Job training was a major initiative in the HELP Act, and this result is highly disappointing. In recent years, other states have made job training a mandatory condition of Medicaid Expansion, and that is something Montana should consider as well.  I-185 would lock in the existing, failed jobs program instead of letting the Legislature make proactive changes that could make it work.

Another major problem that needs to be addressed by the Legislature is the high costs of the program. The cost of Medicaid Expansion is nearly double what the projections were in 2015. The costs levied on taxpayers can be reduced and controlled, but only if the Legislature has the ability to make changes.

A clear first step in lowering and controlling costs is ensuring that our state agencies are using public funds efficiently. It’s widely known that the Medicaid program nationally is rife with waste, fraud, and abuse, but I-185 locks into place Montana’s existing Medicaid Expansion program while bypassing the evaluation the Legislature had in mind when we created the program and not allowing us to make the needed changes.

Medicaid Expansion has been good for Montana families, but it needs to be studied, changed and updated. The special interests funding I-185 seek to prevent the Legislature from doing its job, and in the process they propose to substantially raise taxes and keep in place programs that are not in the best interest of the state.

I’m asking all Montanans to help make Medicaid Expansion better for recipients and less expensive for taxpayers by voting NO on I-185.

Rep. David “Doc” Moore

Missoula