Medicaid expansion repeal could impact Montanans


MISSOULA, Mont. - In 2015 Montana expanded Medicaid to cover adults with incomes of up to 138 percent of the federal poverty line through the bipartisan Health and Economic Livelihood Partnership Act. But with a new Republican Congress in session, it could all change soon.

Democrats are calling the new proposed plan "Trumpcare," but there's no official name yet.

Missoula resident Jerry O'Connell says rather than throwing out Obamacare, Trump should use it as a platform.

"They can change the name of the health care if they want, but they just have to fix it," O'Connell said. "There is too much good work in there to throw it out."

Another person we talked to is worried what might happen if "Trumpcare" takes over Obamacare.

"I think that the current Obamacare system has some issues," Fiona Soper said. "One big concern for people is that the current changes are going to remove health insurance for a lot of people that currently have it."

Here are some key points in the proposed health care plan:

No one is required to buy insurance, but there is a 30-percent surcharge if you don't. There are no government subsidies. The subsidies are replaced with tax credits based on age instead of income. Patients could buy insurance from other states to promote competition. The nonpartisan Congressional Budget Office hasn't come up with how much it would cost yet. States would control Medicaid, but in three years Washington would stop spending money to expand it.

Opponents say the proposed plan would hurt the poor, but backers claim it would save big money.

For more information on the possible impacts for the loss of Medicaid expansion, click here.

Republicans are promising the new plan won't drop coverage to anyone currently on Medicaid. Rep. Greg Walden (R-Oregon) promised Tuesday the plan would not "pull the rug out from anybody."

That includes 70,000 new Montanans made eligible by the Medicaid expansion in 2015.

A report released by S&P Global Market Intelligence predicts between 4 million and 6 million Americans currently on Medicaid would lose their coverage in a few years.

We did the math and the Montana Healthcare Foundation report was more conservative than what the S&P report would suggest for Montana. They estimated thousands less would lose coverage in the state.

The Montana Healthcare Foundation reports the impact of Medicaid expansion in Montana. It contemplates the aftermath of its repeal on access to coverage and care, the state budget and the broader economy, finding that expansion in Montana resulted in:

Increased access to and utilization of preventive care services. 30,000 newly eligible adults accessing preventive care services in the first year of implementation. Increased state capacity to diagnose and treat substance use disorders. More inpatient and outpatient hospital services. A 25-percent decline in bad debt and charity care in Montana hospitals. Nearly $284 million in federal dollars to cover the enhanced coverage and services.

According to the Montana Healthcare Foundation, more than half of all Montanans are insured by Medicaid, Medicare or Healthy Montana Kids.

NBC Montana polled our viewers on whether they support the new health care plan. Unscientific results show 42% of those who responded do support the new plan, while 58% are not in favor. Click here to vote or leave a comment on our informal poll.

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