Medicaid is working for Montana. This is the key finding from two recently released reports by ABMJ Consulting and Manatt Health.
The reports provide new data and insights on the Medicaid program as a whole and new evidence on how the Legislature's 2015 expansion of Medicaid to cover adults with low incomes has benefited our economy, our health care system, and the one in 10 Montanans who now have health insurance because of this new program. Notably, the reports also found that the Medicaid expansion has not over-burdened our state budget: in fact, it pays for itself and has a net fiscal benefit.
Medicaid expansion is a financial win for Montana in several ways, not least among them, the added money it brings into the state. Montana economist Bryce Ward of ABMJ Consulting reported that each year, the program introduces $650 million into the economy, supporting 6,000 new jobs and $400 million in personal income. When we add the revenue associated with increased economic activity with the expansion's savings, the net fiscal impact on the state's budget is positive. In fact, it covers between 110% and 159% of the state's share of the cost of the program.
In addition to paying for itself and saving the state money, Medicaid expansion also supports local Montana businesses and a healthy workforce. 75% of enrollees are working adults, and the new reports found that people only stay on the program for an average of two years. Businesses benefit tremendously from the program: nearly 60% of local Montana businesses have at least one employee enrolled in Medicaid; 25% of businesses have at least a quarter of their employees enrolled.
Medicaid also helps improve the health of Montanans — including those living in our Tribal communities. All told, the program provides health insurance coverage for 265,000 people, two-thirds of whom live in rural Montana. In 2019 alone, 69,000 people went to wellness exams, 69,000 received vaccinations, 138,000 visited the dentist, and 30,000 received mental health treatment. Medicaid expansion vastly expanded the access Native people in the state have to preventive care and specialty referrals. Thanks to greater access to preventive screenings, 3,000 people were newly diagnosed with high blood pressure and 1,300 with diabetes, lowering their risk for heart disease and strokes. And over 5,000 women were screened for breast cancer, and nearly 1,000 cases of colon cancer were averted because of screening and early treatment.
In 2020, Medicaid proved its worth as a safety-net program, providing a lifeline for Montanans who lost work during the converging health and economic crises created by COVID-19. When people lost employment during the pandemic (17% of Montanans applied for unemployment), Medicaid provided a coverage source and helped providers quickly adapt to deliver new telehealth services. As a result of telehealth availability, medical visits increased by 95%, and behavioral health visits increased by 1,400%.
As two of Montana's largest health-focused philanthropic organizations, the Montana Healthcare Foundation and Headwaters Foundation make strategic investments to improve the health and well-being of Montanans. From our vantage point, Montana's Medicaid program as a whole — and the 2015 Medicaid expansion in particular — have created an unprecedented opportunity to address the most critical health issues in our rural state. With five years of experience, it's now clear that the program is working well, achieving its intended aims, and beginning to pay dividends in terms of better health for Montana.
Dr. Aaron Wernham is Montana Healthcare Foundation and Brenda Solorzano is Headwaters Foundation's CEO.