HELENA -- A Republican’s proposal to block any expansion of "Obamacare" in Montana without legislative approval prompted a miniature debate on health-care reform Monday as Democrats attacked the measure as blocking health-care solutions.
But Rep. Matthew Monforton, R-Bozeman, said his measure merely ensures if Montana is to take any steps to expand the Affordable Care Act here, the Legislature must approve it.
“It doesn’t decide what we should do about Obamacare issues but rather helps decide who makes that decision,” he told the House Human Services Committee. “It’s (my) idea that it should be made by the people’s representatives and not an administrative agency behind closed doors.”
Monforton’s House Bill 256, if passed, expressly forbids any expansion of Medicaid or establishment of a state-run, online health-insurance “exchange” or marketplace unless the Legislature approves either one.
Medicaid is the state-federal program that pays medical bills for the poor. Whether to accept federal funds to expand it to cover 70,000 low-income Montanans is one of the biggest issues before the 2015 Legislature.
Monforton said he believes under current state law, Gov. Steve Bullock, a Democrat, could expand Medicaid without legislative approval.
Bullock is supporting a bill that seeks legislative approval of Medicaid expansion, and has not indicated that he intends to expand the program without that approval.
Democrats on the House Human Services Committee Monday peppered Monforton with questions, saying HB 256 looked like a cookie-cutter, anti-ACA proposal designed to block any solutions if anything goes awry with current ACA programs.
Rep. Denise Hayman, D-Bozeman, asked how the bill would help the 40,000 Montanans who might lose federal health-insurance subsidies if the U.S. Supreme Court this year strikes down part of the law allowing the subsidies.
Monforton said if lawmakers are concerned about that possibility, they could attempt to take action now during the 2015 Legislature, to set up a state-operated marketplace or take other steps to help those who bought policies with a subsidy.
The U.S. Supreme Court is expected to rule this summer whether federally run marketplaces, such as in Montana, are allowed to offer the subsidies to those who buy policies through the marketplace.
Amanda Harrow of the Montana Primary Care Association, which represents health clinics around the state that serve many low-income customers, opposed HB 256, saying it could eliminate administrative options to re-creating a marketplace that provides the subsidies.
The subsidies brought $93 million to Montana last year, she said, to help pay for the policies: “We need to keep all options on the table and keep every opportunity open to address the needs of these people.”
Rep. Art Wittich, R-Bozeman, the chair of the panel, asked Harrow if she knew any way a state-run marketplace could be created without legislative approval.
She said she’d research the issue and get back later to the committee, which took no immediate action.