TL/DR –
Montana currently assists more than 250,000 predominantly low-income residents with healthcare through Medicaid, a state-federal partnership that sees the federal government covering 80% of costs. Medicaid not only supports lower-income individuals and families but also helps keep overall healthcare insurance costs down and benefits the state’s economy. However, procedural challenges associated with reapplication and maintaining eligibility have resulted in approximately 120,000 Montanans, including 18% of children, losing their Medicaid coverage, despite federal healthcare authorities twice requesting changes to this process.
Medicaid Impact and Concerns in Montana
Health care is a universal need, and in Montana over 250,000 individuals, predominantly from low-income backgrounds, rely on Medicaid—a state and federal partnership. The federal government shoulders most of Medicaid’s costs, amounting to an average of 80% of total expenditure. In 2022, it allocated $1.8 billion for Montanans’ health care, a majority of which benefit those living in rural areas.
Medicaid serves not only low-income families, children, and pregnant women, but also supports individuals with severe disabilities. It plays a vital role in reducing the number of uninsured individuals, thereby reducing health care insurance costs for everyone and pumping money into Montana’s economy.
Beneficiaries of Medicaid in Montana
Medicaid has significant economic impacts, including keeping health care facilities open through reimbursements and helping small businesses that cannot afford to provide health insurance for their employees. It is particularly critical for Native American Montanans due to the underfunding of the Indian Health Service. Medicaid enables them to access a wider range of health care providers, with the federal government reimbursing 100% of the costs.
Medicaid Eligibility Issues and Implications
However, over 120,000 Montanans have lost Medicaid coverage due to procedural mishaps during eligibility reviews after the COVID Public Health Emergency. The process is often difficult and confusing, resulting in almost a third of Medicaid recipients being denied, not for eligibility, but mostly for technical or procedural issues. This has led Montana to have one of the highest rates of health insurance termination for children in the nation.
Medicaid recipients often face long telephone waits and multiple attempts to provide necessary documentation. Worse still, some are unaware their coverage has been terminated until they visit their healthcare providers. This raises questions about the state administration’s commitment to reducing bureaucracy.
Call for Process Improvement
Due to these issues, federal health care authorities and local health care providers, like the Montana Chapter of the American Academy of Pediatricians, have called for changes to the process, including a 30-day pause to prevent further children from losing coverage. Yet, state officials appear focused on reducing the number of Medicaid recipients, which could have negative impacts on public health and the economy.
Future Implications
If this trend continues, it may be an indication of what’s to come. Montana’s Medicaid program must be renewed in the 2025 legislative session. Despite the program’s essential service, the current purge might lead to dire consequences, especially when many of those losing Medicaid require mental or behavioral health services that they will no longer be eligible for under the new guidelines.
The state administration is urged to stop dismantling Medicaid and to clarify how they plan to replace the $1.8 billion in federal Medicaid program funding while continuing to provide health care services to Medicaid-eligible individuals.
—
Read More Health & Wellness News ; US News