Medicaid Expansion Bill Would Allow Self-reporting of Work

A Republican lawmaker who wants most Medicaid expansion recipients to work or attend job training has updated his draft bill to ease reporting requirements after an analysis predicted tens of thousands of people could lose their coverage by failing to meet the reporting terms.

Democrats are criticizing Republican Rep. Ed Buttrey's proposal to nix coverage for those who do not complete 80 hours per month of work, job training or searching, education, volunteer work or mental health treatment, with some exemptions.

His initial bill called for the state to track their compliance every three months.

A new draft of Buttrey's proposal would instead allow people to self-report their work, volunteer or other "community engagement" hours by phone, in writing or electronically. His measure proposes the state verify a percentage of those reports.

Democratic Rep. Mary Caferro, who is sponsoring a bill to continue Montana's Medicaid expansion program substantially as it is, said Tuesday the work requirement is a bad policy and isn't cost-effective. About 3,700 out of 96,000 people covered under Medicaid expansion aren't working, the state has said.

Caferro's bill would continue Montana's voluntary job training program for Medicaid expansion recipients, which supporters have said is being considered by other states.

Buttrey and Caferro co-sponsored the initial Medicaid expansion law in 2015. The program ends on June 30 if lawmakers can't reach an agreement.

Their separate measures this session both include a fee of just under 1 percent of hospitals' revenue for outpatient services to help support the program. The hospitals agreed to the fee in exchange for a higher reimbursement rate for services provided to Medicaid recipients.

Buttrey's latest proposal would require the Montana State Fund, the quasi-governmental workers' compensation program, to pay a 2.75 percent premium tax. It also would limit coverage to U.S. citizens and people who are legally in the country and who are considered Montana residents.

Caferro said the bills are scheduled for a hearing on Saturday, March 16 — a week later than was initially planned.