House panel votes down expanded Medicaid

Chippewa Cree Business Committee member Dustin Whitford said that in his life he has heard two myths repeated time and again.

The first myth, he said, is that at Easter time a bunny comes around and gives treats to young people, he told the Montana House’s Human Services Committee at a marathon meeting in Helena Friday night.

“The second myth is that Indians get free health care,” he said.

Whitford’s comments were a light spot in a tense meeting about Gov. Steve Bullock's proposal to expand Medicaid to include 70,000 people who aren’t covered by the Affordable Care Act but make too much money to qualify for the existing Medicaid program.

Many Natives, he said, are in need of help paying health bills. About 20,000 of the 70,000 Montanans eligible for help under Bullock’s plan are Natives, it is estimated.

The committee voted 10-7, along straight party lines, to submit an unfavorable report to the full House on the proposal. Usually, committees simply reject a proposal.

That maneuver means that 60 House members will be needed to pass the legislation on the floor. Supporters were planning unanimous support from the 41 House Democrats and hope to attract 10 Republicans to join them to pull the legislation from the committee. They are not at all certain they can get the 60 votes to pass it.

Rep. Stephanie Hess, R-Havre, the only Hi-Line representative who sits on the committee, voted with fellow Republicans to kill the bill.

More than 250 people packed the old Supreme Court chambers in support of the Bullock plan. For three hours, they took turns addressing the committee.

Nineteen people spoke against the plan in the session that went well into Friday night.

Whitford said that Indian Health Services was “a payor of last resort,” and often doesn’t have money to provide needed health services.

Last year, he said, the tribe had to pay off-reservation health care providers a great deal of money to provide medical care they couldn’t get through Indian Health Services, among them $1.9 million to Northern Montana Hospital in Havre, $1.2 million to Benefis Medical Center in Great Falls and $233,000 to Great Falls Clinic

In all, he said, the tribe pays nearly $6 million to off-reservation providers.

Sen. Jonathan Windy Boy, D-Box Elder, testified in support of the governor’s proposal.

Indian Health Services is underfunded and can’t provide the needed services to 9,000 enrolled Chippewa Cree members, Windy Boy said.

The federal budget is on an Oct. 1 to Sept. 30 cycle, Windy Boy said.

“The story on the reservation is that if you get sick, get sick before June,” he said. “After that, the money runs out.”

A representative of Bullhook Clinic was scheduled to testify at the session, supporters of the proposal said, but she had to return to Havre.

During the hearing, long lines of people waited to testify in behalf of Bullock’s plan.

Many were near tears when they spoke of medical problems they had because they made too much money to qualify for traditional Medicaid but not enough to pay for insurance.

Business, political, labor human rights groups and joined religious leaders in speaking in behalf of the legislation.

Opponents stressed their concern about the fiscal impacts.

For the first two years of expanded Medicaid, the federal government will pick up the entire cost. After that, the state will pay 10 percent.

Ed Apgenbright, recalled that when he was superintendent of public instruction in the 1980s, many federally funded programs came with mandates.

“The money eventually disappeared but the regulations remained,” he said.

A physician from Kalispell said she was concerned that the new patients under the program would swamp the already overworked doctors.

And Committee Chair Art Wittich, R-Bozeman, questioned how many people would actually be served under the program.

He said all he knew of Bullock’s estimate of 70,000 people was “that’s what is on all the T-shirts.”

In a statement after the vote. Bullock said he would continue the fight for expanded Medicaid and blamed the vote on “out-of-state dark money groups.”