2025 Legislative Session
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Medicaid Expansion in 2025!
One of the largest healthcare initiatives is removing the sunset for Medicaid Expansion. Medicaid was expanded in 2017 after a long-fought battle for the ability to provide healthcare services to the needy in Montana. To date, Montana has seen tremendous economic benefit from expanding Medicaid.
See two recent objective report here:
https://mthcf.org/resource/medicaid-in-montana-2023/.
You can also review the county Medicaid impact reports from the Montana Budget and Policy Center Montana’s Medicaid Keeps Counties Healthy | Montana Budget & Policy Center
It’s imperative that we remove the sunset for Medicaid Expansion and make it the way we do business in Montana.
We have two main reasons for wanting to remove the sunset:
- As of 2025, those aged over 65 will be the largest demographic in Montana. To be able to continue our economic growth in Montana, we will need all hands on deck for the workforce. That includes adults who need Medicaid expansion to be treated for ongoing mental health issues or substance use disorders.
Here are some talking points for that issue:
- 76% of Montana’s adult Medicaid enrollees aged 19-64 reported working full time, working part time, or attending school.
- In 2021, more than 61,000 expansion enrollees utilized preventive services, more than 34,000 received mental health services, and more than 5,500 received substance use disorder treatment.
- Medicaid expansion generated state budget savings of more than $27 million in SFY 2022 by providing higher match rates for some existing Medicaid populations and by replacing existing state spending with new federal dollars.
- Uncompensated care costs for Montana’s Critical Access Hospitals declined by 35% between 2016 and 2021 with no rural hospitals closing during that time.
2. Montana has a large number of children in the welfare system and foster care. Although we have made gains in reducing those numbers, there are still a large number of children that must seek treatment outside of Montana until we can reopen the treatment houses/beds that were closed during COVID.
- Over 50% of the children removed from homes for neglect, have one or more parent with a substance use disorder or mental health issue. If we want to have those children returned as soon as possible to their families, we need to ensure that Medicaid Expansion is available to treat the adults and return those children to healthy families.
- Creating healthy families and lives for children, creates a future generation of healthy Montanans to ensure the long-term stability of our communities and state.
Increase Reimbursement for Behavioral Health Medicaid Services
BHAM has worked with DPHHS to introduce a bill for biannual cost reporting for Behavioral Health Medicaid Programs. This bill would give DPHHS the information to set rates so that costs of providing the care are covered. The original 2021 Medicaid Rate Study that developed benchmarks for the cost of care were based on 2020 budgets. Five years have passed since then and costs have only increased, as has inflation. While all sectors of behavioral health are reimbursed below the cost of delivering care, the hardest hit sectors are adult behavioral health and substance use disorder treatment providers. BHAM will be advocating for raising the Medicaid rates to at least cover current costs of delivering care.
Mary Caferro (D) Helena is also introducing a bill that calls for regular inflationary increases for Medicaid providers. BHAM will be supporting that bill as well.
We’ll be adding talking points for various bills as they are introduced this session.
Prioritized Behavioral Health System for Future Generations Recommendations!
Priorities Approved by the Governor
Tier One: Behavioral Health Priorities
- Expand the Service Delivery System to Support Individuals with Complex Needs.
- Enhance the Targeted Case Management Program.
- Implement a Care Transitions Program.
- Redesign Rate to Improve In-State Youth Residential Services.
- Expand and Sustain Certified Community Behavioral Health Clinics.
Tier Two: Other Priorities
- Adopt Electronic Bed Registry and Enhance 988.
- Invest in School-Based Behavioral Health Initiatives.
- Incentivize Providers to Join the Behavioral Health and Developmentally Disabled Workforce.
We’ll be updating these priorities with talking points as they are introduced at the 2025 Legislative Session.