by Rep. David Bedey, HD 86, Hamilton
Across the state, Montanans have been treated to yet another mailer from Americans for Prosperity (AFP), a right-wing special interest group. This one attacks Republican legislators who voted for HB 245, a bill that reauthorized Montana’s Medicaid expansion program and enhanced its work/training requirement provisions. The bill passed with bipartisan support, including 37% of Republican legislators.
AFP misleads voters by insinuating that supporting this bill is akin to fully supporting “Obamacare,” which is a multipart federal program that Congress passed into law 15 years ago. This is obvious nonsense.
But if support for Medicaid expansion merits censure, then why hasn’t AFP attacked Governor Gianforte—who is on record since as early as 2020 opposing cancellation of the program?
And why hasn’t AFP called out President Trump? Neither the first nor the second Trump administration ended Medicaid expansion. In fact, the president—joined by Montana’s entire congressional delegation—recently reauthorized the federal program with the welcome inclusion of work requirements for those not in school but who are able to work. (Montana’s program has called for work requirements since 2019, but up to now the federal government has not approved them.)
I’ll leave it to you to guess what drives AFP’s hypocrisy. But its propaganda campaign recklessly detracts from thoughtful consideration of this important issue.
For those serious about healthcare policy in Montana, consider the following facts:
• To be eligible for Montana Medicaid expansion, one must be very poor, e.g., a single person earning less than about $21,000 annually or under $36,000 for a family of three).
• Of these enrolled in the program, 72% are working (two-thirds of them full time), 10% are disabled, 7% work at home as primary caregivers, and 4% are in school, according to the latest report from Montana’s Department of Labor & Industry.
• Montana Medicaid expansion funds treatment for mental health problems and for substance abuse disorders, both of which are on the rise in our state. Since the program brings in nine federal dollars for every one dollar of state spending, its elimination would either put a severe strain on the state budget or leave mentally ill addicts on the streets to fend for themselves.
• In the absence of the program, poor people would receive treatment in hospital emergency rooms. Hospitals have a moral and legal obligation to provide this care but are not compensated for it. This in turn threatens the financial stability of our rural hospitals—likely reducing the availability and quality of healthcare for most Montanans.
The long-term fiscal viability of the entire federal Medicaid program is in question, which is an urgent matter that Congress must address. But in the meantime here at home, Montana Medicaid expansion provides a safety net for the working poor, helps combat the mental health and substance abuse crisis, and protects our rural hospitals.
Abruptly ending the program would be an act of legislative malpractice inconsistent with prudent conservative governance. It is incumbent upon those seeking to terminate Montana Medicaid expansion to honestly acknowledge the consequences and offer serious alternatives. But don’t expect any help from ideologues like those at AFP.
Tim Adams says
1) Medicaid expansion was part of the original Obamacare legislation. It’s a fair point to say if you support Medicaid expansion you’re supporting extension and continuation of Obamacare.
2) Trump and Gianforte are not on the ballot again. Both are in their 2nd terms so neither is going to be running again, presumably.
I generally agree with Mr. Bedey in not wanting the libertarians running the MTGOP and local Central Committee in charge since they have no vision of government beyond cut, cut, cut.
However, Medicaid expansion was passed in 2010 along with the rest of the Obamacare bill and I also agree there’s not much to be gained by attacking people who aren’t going to continue in their roles as policymakers.
Helen Sabin says
THE MONTANA AFP is another gaslighted group led by someone who doesn’t know a fact from a hole in the ground – but is using the reputation of the AFP for his own ideology that is not based on FACT. I used to sing praise to the AFP but this Montanan group is not the AFP who helped Republicans get rid of their state leader in Colorado – got him out along with an ideologue like this MT group leader. He needs to be removed and Bitterrooters need to write the AFP and suggest that,