Sen. Cary Smith, R-Billings, speaks in favor of Senate Bill 101, which would establish guidelines for direct provider care. (Montana Public Affairs Network)
A House panel Monday afternoon voted to table legislation that would end Medicaid “continuous eligibility” in Montana and require state health officials to cross-check public assistance eligibility across a series of databases after several Republicans joined Democrats in opposing the bill.
Without explaining their votes, Reps. Sharon Greef, R-Florence, Greg Frazer, R-Deer Lodge, Mallerie Stromswold, R-Billings, Tom Welch, R-Billings and Ed Hill, R-Havre, joined Democrats in supporting a motion to table the bill 12-7. The legislation can still be taken off the table and sent to floor, but the vote Monday was the first time significant GOP opposition arose to the proposal.
SB100, sponsored by Sen. Cary Smith, R-Billings, and backed by the conservative think tank Foundation for Government Accountability, was marketed by Republicans as a way to reduce fraud in the welfare programs like Medicaid and the federal Supplemental Nutritional Assistance Program. The state would need to verify an individual’s eligibility against data including criminal records, immigration and assistance payments in other states.
And it would end 12-month continuous expanded Medicaid eligibility, meaning that Montana would no longer be one of two states that presumes that people on Medicaid are eligible for a whole year, instead requiring more frequent eligibility checks.
Opponents to these proposals, among others that the GOP has authored this session, say that tightening these standards will lead to “churn” — or eligible Montanans losing their state assistance and healthcare due to the grinding gears of bureaucracy. A fiscal note for the bill estimated that thousands would need to reapply for their benefits under the proposal, and said that around 50 possible cases of welfare fraud are investigated by the state each year.
A study from researchers at George Washington University said that lawmakers overstated the possible savings from rooting out whatever fraud might exist while understanding how many could lose their coverage even if eligible. The study said that as many as 22,000 Montanans on CHIP or Medicaid would be impacted by the removal of continuous eligibility alone.
Rep. Jessica Karjala, D-Billings, said Democrats knew ahead of time that some Republicans would vote against the bill, leading to Rep. Alice Buckley, D-Bozeman, making a motion to table the bill during executive action.
“It worked as planned. This was probably my most hated bill,” Karjala said.
Frazer and Stromswold are moderates who often buck the party line. Neither could be reached for comment. Hill’s vote came as more of a surprise to minority lawmakers.
“I think there was some confusion on my part. I was looking at it a couple different ways,” Hill said. “I don’t want to see increased government, more hoops to jump through, but I am all about eliminating fraud, whether it’s one case or 100. It is what it is, but I think with hindsight I probably would favor that bill. It seemed to me like I got called out by a phone call. Rep. Greef, sitting next to me, her husband got hit by a car crossing the street. Maybe that’s when I lost my focus.”
Although SB100 is halted, a provision eliminating continuous eligibility remains in the state’s main budget plan, HB2, marked by a nearly $11 million reduction in spending.
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