If Feds Block Premium, Medicaid Expansion Goes Back to Legislature

If the Obama administration fails to approve a key provision included in Montana’s Medicaid expansion plan, then supporters will have to come back to the Montana Legislature for approval of Medicaid expansion yet again.

That’s the word from Susan Byorth Fox, the executive director of Montana’s Legislative Services Division, who responded to my e-mail Thursday.

FOX:”The effective date would indicate that until all waivers and approvals necessary are approved, the bill is not effective, so I think they would need to come back to the legislature to implement anything other than what SB 405 specifies.” 

Fox cited this portion of the law in particular:

Section 27. Effective date – contingent effective date. (1) Except as provided in subsection (2), [this act] is effective upon approval by the U.S. department of health and human services of all waivers and approvals necessary to provide medicaid-funded services to individuals eligible pursuant to [section 4] in the manner provided for in [sections 1 through 17].

(2) [Sections 11 (oversight committee), 19 (med mal), 20 (stat approp), and 21 (Med mal)] and this section are effective on passage and approval.



Aaron Flint posted on July 08, 2015 16:05

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The Obama administration is unlikely to approve a key provision included in the Montana Legislature’s approved version of Obamacare Medicaid Expansion.  So, what happens if the Obama administration takes out a key provision of the Montana law?  Is it no longer going to be implemented without approval from the legislature?  That would seem to be the obvious answer…

MTPR.org: Feds Unlikely To Approve Montana Medicaid Expansion Plan In Its Entirety

The waiver Montana is requesting asks for permission to do several things that are not standard Medicaid practice. Perhaps the most contentious is requiring new Medicaid recipients to pay a premium of up to 2% of their income in exchange for coverage.

That last bit, about approving Medicaid premiums for those above the poverty line is crucial, because Montana’s Medicaid expansion proposes charging everyone in the new, expanded Medicaid program premiums, even those below the poverty line.

Alker thinks the feds are likely to negotiate for that to be dropped.

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