Montana state capitol building, via Bigstockphoto.com
The hits keep on coming! A new survey of Montana Medicaid expansion enrollees confirms that Medicaid expansion dramatically improves access to health care, as well as overall health. Almost 70 percent of survey respondents reported improved access to medical care overall, while half reported improved access to dental care and nearly half reported improved access to behavioral health services. Additionally, almost half reported that their general health has improved since the state expanded Medicaid. Now that’s something to celebrate!
The survey results now stand in a long line of evidence that confirms the many benefits of Medicaid expansion, including the fact that it reduces medical debt, helps rural hospitals stay open and improves state budgets. Not only that, but Medicaid expansion improves health outcomes by increasing early cancer detections, reducing smoking rates and increasing the rate at which children receive well-child visits.
Unfortunately, the over 95,000 Montanans enrolled in Medicaid expansion are now at risk of losing these benefits because the future of the program hangs in the balance during this year’s state legislative session. The program is set to expire at the end of June this year, and legislators are currently debating whether to re-authorize it, as well as how. As part of the re-authorization negotiations, Republican legislators are debating whether to add harmful barriers such as work requirements and high premiums.
Republicans say they want to impose these new restrictions because they want to make Medicaid expansion enrollees have “skin in the game” and an increased sense of “personal responsibility,” but the true intended purpose of imposing barriers such as work requirements is to kick individuals off of coverage as a purported way to save state budget money.
Both these stated goals, of creating “skin in the game” and saving state budget dollars through imposing barriers, are fallacies. They are “sheep’s clothing” disguising the “wolf” that signifies individuals losing coverage. Attempts to “put skin in the game” only cause people to lose coverage, rather than instill personal responsibility or promote financial independence. Additionally, forcing individuals to lose their coverage increases, rather than decreases, costs for states by causing them to spend more of their state dollars on uncompensated care when those individuals become sick, often after foregoing preventive care.
If policymakers truly want to help individuals work and increase their financial independence, the best way to do so is to allow them to maintain health coverage while working or looking for work. Montana already has a program that does exactly that, called HELP-Link. HELP-Link is a voluntary work program that offers individualized job-support services. In its first two years, HELP-Link contributed to a 6 to 9 percent increase in workforce participation among Medicaid expansion enrollees. As of 2018, 78 percent of HELP-Link participants who were unemployed during 2016 found employment after completing the program, while 51 percent of HELP-Link participants had higher wages after completing the program. This data demonstrates that access to health coverage, combined with tailored work support services, can be a winning formula in helping Medicaid enrollees work.
The success of Montana’s Medicaid expansion and HELP-Link programs signifies they should both continue without the imposition of harmful new barriers or cuts. Advocates in the state, along with their coalition partners, will be highlighting the benefits of each program for the press and policymakers during the current legislative session to push for preservation. With June 30 nearing, time is of the essence for Montana’s Medicaid expansion.