The Montana Legislature is debating a proposal from Gov. Steve Bullock to expand the Medicaid program to insure about 70,000 Montanans who are now without health insurance.
No issue this session has generated the emotion and the controversy of this legislation.
In a nutshell, Medicaid, which presently serves poorer Montanans, would be expanded to include many working poor who are not insured by the their employers.
The expansion would cost the state virtually nothing for three years. The federal government, under the Affordable Care Act, or Obamacare, would pick up the cost. After three years, the federal government would still pay most of the money needed, but the state would pick up some.
Bullock and other supporters point out that hospitals and small community clinics would benefit because they will get paid for treating some people who are now unable to pay their bills.
Many of the other benefits are obvious.
Jobs would be created in the health care field because more people will be needed to treat the Medicaid recipients.
People will seek medical attention when they first get sick, not wait until they are seriously ill.
Costly emergency room treatments will be reduced because people will seek routine care before their illness gets that serious.
But the most important argument for the Medicaid expansion is that it is the decent thing to do.
Montanans by their western heritage are rigidly independent folks until they need help, then neighbors willingly and vigorously pitch in. Thousands of Montanans need help to maintain their health and their dignity, and here is an opportunity for all of us to help out.
The opponents of Medicaid expansion are fine people who make good neighbors, but they have failed to make their case against the governor's proposal.
They point out that Medicaid payments are not sufficient for doctors and medical clinics. Maybe so, but they are certainly better than nothing, and that's what many health professional get for treating sick people now.
Opponents say that the federal government is going broke, and the feds will have to cut back on their support for Obamacare in future years, so it's best not to make the commitment to the working poor at all. Congressional budget officials insist that Obamacare will save money for the federal government.
The long, arduous battle to adopt Obamacare inflicted psychic wounds on many people, and most were displeased with the final outcome. The road to Obamacare was like the story of a committee trying to build a horse. We ended up with a camel. But with interests as conflicting and varied as the insurance industry, doctors, nurses, patients, clinics, the U.S. Chamber of Commerce and politicians of every political stripe chipping in their two cents, it is hard to imagine how anyone could be pleased with every aspect of the final result.
The Legislature doesn't face the option of Obamacare or the perfect — it must decide on Obamacare or nothing.
When you hear health professionals tell the harrowing tales of people delaying treatment until they are in dire pain or seriously ill, it's clear that the choice of nothing is not acceptable.
Three members of the Hi-Line's delegation to Helena — State Sens. Jonathan Windy Boy and Greg Jergeson and Rep. Clarena Brockie — are supporting the expansion.
Reps. Wendy Warburton and Kris Hansen are reluctant. Warburton and Hansen are tremendous people who care deeply about Montana and this very special part of the Treasure State that we hail from.
We plead with them to maintain their long commitment to health, human dignity and life. We plead with them to reconsider and vote for Medicaid expansion.