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Mick Ringsak


Medicaid became effective in Montana in July 1967. As of June 2011, Montana’s Medicaid program was providing coverage for 60,800 children, 19,900 adults, 10,500 elderly, and 19,600 disabled residents

A total of 178,846 people had coverage in Montana’s Medicaid/CHIP programs as of June 2015, which was an increase of 20 percent over the 148,974 people who had coverage at the end of 2013. By January 2017, after the expanded guidelines had been in place for a little over a year, total Medicaid/CHIP enrollment in Montana had grown to 246,548 people — a 66 percent increase since the end of 2013.

In 2017 the Montana Health Care Association, the Major Sponsor and Funder of Initiative I-185, hired Manatt Health Strategies, LLC, wholly owned by Manatt, Phelps & Phillips, LLP, one of the nation's premier law and consulting firms, to compile a report “The Impact on Montana of the AHCA’s Medicaid Provisions.”

The MHCA received the report on June 13th, 2017, fully 17 months before I-185 would be voted on by Montana taxpayers. The Montana Health Care Association never released the information in this 36-page report to the voting public. The Montana Health Care Association and the executive branch are now pressuring our elected representatives to legislatively enact I-185 “Expanded Medicaid”!

On Page 19, the Manatt study states the following: “Maintaining Current Medicaid Program Likely Not Feasible" ... "Montana would have to increase State General Fund spending to unsustainable levels to maintain current Medicaid program spending under the AHCA"

During FY 2020-2026, Montana would have to increase its own spending by over $2 billion, or about 42%, to replace lost federal funds from expansion financing changes and the per capita cap.

On Page 34, the study notes: “Montana is expected to lose $4.8 billion in federal Medicaid funds between federal FY 2020 and 2026 due to the AHCA’s elimination of enhanced match for expansion, reflecting 35% of Montana’s current-law federal Medicaid funding." The ACHA maintains enhanced federal Medicaid funding for existing expansion states through 2019, but eliminates enhanced funding in 2020 except for “grandfathered” adults.

Total enrollment in 2017 amounted to 254,000 individuals. Total federal and state Medicaid spending for Montana during 2016 amounted to about $1.4 billion. The federal government paid 67.2 percent of these costs, while the state paid the remaining 32.8 percent. Medicaid accounted for 17.4 percent of Montana's budget in 2015.

Estimates based on data from CMS (Center for Medicare & Medicaid) as of August 2018 show that the total Medicaid spending in Montana for FY 2017 was $1,791,510,872.

Medicaid expenditures do not include administrative costs or accounting adjustments, as per the Kaiser Family Foundation, 2018.

The current cost of Medicaid in our Montana state budget paid for by Montana taxpayers is $600 million.

Montana’s Extended Medicaid program is not the only program that is

“unsustainable." The entire U.S. healthcare system is unsustainable in its current form.

Rather than legislating more spending and creating additional Band-aids for a broken system, the legislatures, both state and federal, need to be implementing programs that will solve the crisis in health care permanently.

The projected cost for Medicaid in Montanans in the 2019 HB2 Biennium Appropriations is $832,168,974.00 (15%) while ALL Other Appropriations will total $4,744,299,508 (85%) without Medicaid expansion. {Source: MT Legislative Fiscal Division}. Nationally the Medicaid costs will be $412 billion in FY 2019. It is administered by the states. Medicaid and Medicare spending together now exceed the total spent on the Social Security program.

Out of the 33 developed countries, 32 have universal health care. On average, other wealthy countries spend about half as much per person on health than the U.S. spends. Health consumption expenditures per capita in U.S. dollars for 2017 is $10,224.00 vs $5,280.00 for a comparable country average.

This Country needs a healthcare system that will address the needs of all Americans and contain the cost of pharmaceuticals and healthcare services and return doctors to practicing medicine and not accounting!

Deficit spending is not borrowing money, it’s stealing from future generations.

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Elton W. “Mick” Ringsak of Butte is a Major in the U.S. Army Reserve. He served in Vietnam, 1967-68, and is a former regional adminstrator of the Small Business Administration.


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