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Gov. Bullock signs, touts major health-care bills from 2019 Legislature — including Medicaid expansion

HELENA — The 2019 Legislature’s work on health care took center stage Thursday, as Gov. Steve Bullock signed several bills to address health-care problems in the state — including the granddaddy of them all, Medicaid expansion.

“These priority bills work together to protect the progress that our state’s made in recent years, to provide quality and affordable health care to all Montanans,” Bullock said at a packed bill-signing ceremony in the Capitol. “It will further our efforts to increase access, reduce costs and improve the quality of care.”

Bullock signed four health-care bills Thursday and did ceremonial signings for five others that had been signed into law earlier. They addressed issues ranging from the cost of prescription drugs to mental illness to suicide prevention.

The biggest of the bunch was House Bill 658, which continues Montana’s Medicaid expansion — a $1.5 billion program over the next two years, that provides government-funded health coverage to 96,000 low-income adults in Montana.

Bullock touted the measure as an example of bipartisan cooperation to preserve a program started in 2015 and that has created jobs and economic development to the state while bringing health coverage to many who’d gone without for years.

“When I stood before the legislative body in January for my fourth and final State of the State (address) I asked that we continue what has been, really, the greatest jobs bill that we’ve had in our state,” he said. “I asked that we continue what has given Montanans health care, both physical and mental, that allows them to work and not be one medical bill away from bankruptcy.”

HB658, sponsored by Rep. Ed Buttrey, R-Great Falls, continues the program past a June 30 expiration deadline. It adds some additional eligibility requirements, such as 80 hours a month of “community engagement” for participants.

But many participants are exempt from those requirements, and state health officials have estimated that as many as 90,000 people on the program meet the requirements or are exempt. The program pays medical bills for adults earning up to 138 percent of the federal poverty level, or about $17,200 of annual income for a single person.

The bill was approved by a coalition of minority Democrats and moderate Republicans in the Legislature.

Rep. Mary Caferro, D-Helena, a co-sponsor of the bill, thanked Montana voters Thursday for “sending enough of the right people to Helena to get it done.”

The federal government covers about $1.4 billion of the cost of Medicaid expansion in Montana. A new tax on Montana hospitals will help pay for most of the remainder of the program’s cost. The state treasury’s net cost is about $16 million, according to an analysis by the Bullock administration.

The governor signed three other bills Thursday and highlighted five others, including:

• Senate Bill 125, sponsored by Sen. Steve Fitzpatrick, R-Great Falls, to create a reinsurance program designed to backstop the health-insurance market in Montana and reduce premiums for some consumers. It was signed last week.

• Three bills affecting pharmacies and prescription drugs, including one that prohibits certain practices by pharmacy-benefit managers, which are multibillion-dollar companies that determine prices and availability of certain drugs for consumers.

However, Bullock also vetoed a bill Thursday that would have further restricted pharmacy-benefit manager practices.

• House Bill 660, from Rep. Joel Krautter, R-Sidney, to create grants for mobile crisis unit teams to treat people with mental illness. It was signed Thursday.

• Senate Bill 30, sponsored by Sen. Jen Gross, D-Billings, allowing Medicaid reimbursement for peer-support services, which help treat the mentally ill. It had been signed Wednesday.

• House Bill 599, from Rep. Jonathan Windy Boy, D-Box Elder, to establish community health aides on Montana’s Indian reservations. Windy Boy said it will greatly increase health-care options on reservations. It was signed Thursday.

• House Bill 696, sponsored by Rep. Jessica Karjala, D-Billings, providing $500,000 for grants for suicide prevention programs, with a special emphasis on veterans. It was signed Thursday.

Mike Dennison

Mike Dennison

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